Customer Experience Officer-Medical
The role holder will be responsible for answering calls in a professional and informative manner and CRM case logging as necessary. Provide timely and appropriate responses to clients and/or assign tickets to the right person or department.
Handling customer queries, complaints, instructions received through call and email communication
Interact with clients, intermediaries, and service providers to ensure that the care is given within policy guidelines;
Set the appropriate parameters for admission cases i.e. claim reserve, initial authorized cost, cover benefits and duration;
Respond to queries from clients, intermediaries, and service providers through answering telephone calls, interviewing clients, and verifying information. Liaise with underwriters on the scope of cover for the various schemes benefits ;
Ensure that medical scheme members are attended to round the clock;
Prepare periodic care reports for management on medical matters/ issues;
Perform any other duties as may be assigned from time to time;
Maintains and improves quality results by adhering to standards and guidelines; recommending improved procedures with a QA score target 95%;
Ensure clients outpatient approvals are issued via email as per SLA;
Facilitate admissions and discharges appropriately;
Maintains communication equipment by logging in interactions through CRM for traceability / visibility;
Maintain and monitor telephone budget allocation to ensure lines are diverting to E1 lines
Qualifications and Experience
Diploma in Nursing or related medical field
3 – 5 years in a similar role
Knowledge of insurance regulatory requirements
Knowledge of Britam products and services
MODE OF APPLICATION
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Britam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi. The group offers a wide range of financial products and services in Insurance, Asset management, Banking and Property. Our Mission is to provide outstanding financial services to our customers. Our Vision is to be the most trusted financial service partner. We aim to provide our clients, with an unmatched offering, ensuring first class solutions that help secure the future.