Job Description

Key responsibilities/What you do:

• Builds a customer-oriented focus in the Care Centre by providing quality actions and resolutions to their concerns and queries.
• Follows communication/update expectations with clients, in accordance with the Nextcare policies, scheme or agreed time frames set.
• Answers inbound calls as well as assist customers/providers who have specific inquiries.
• Outbound calls for follow up cases, additional medical reports, second medical opinion, complaints. Etc.
• Builds customer’s interest in the services and products offered by the company.
• Provides personalized customer service of the highest level.
• Updates the existing database with changes and the status of each existing/prospective customer/member.
• Documents details of telephone conversation and actions taken.
• Corresponds with Care Centre – Team Leader and Care Centre – Assistant Manager and keep an open channel of communication.
• Maintains records and close-loop each call by completing the clerical duties, as well as liaising with other departments.
• Analyzes the various parts of a problem properly and develop logical solutions within the permitted scope of work.
• Efficiently adjudicate pre-approval claims that exceed the standard Turnaround Time (TAT) to ensure timely resolution.
• Issue Guarantee of Payment (GOP) documents as required to facilitate seamless service delivery..

AI READINESS Work effectively in an environment shaped by artificial intelligence (AI), machine learning, data analytics and cloud-based tools, using insights responsibly with our standards of data governance, security and ethical use.

Key requirements/What you bring:

• Bachelors Degree ; Medical background preferred.
• 2+ years experience in a Call Centre/ Customer Service environment, TPA Hospitals or Medical Centers exposure a plus .
• Physically fit to carry out duties.
• Legally permitted to work in the country of operations.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.