Customer Experience Associate at Britam

Job Purpose and Key responsibilities

Job purpose

The role holder will be responsible for answering calls and emails in a professional and informative manner and account for the interactions in the CRM system.Provide timely and appropriate responses to clients and/or assign tickets to the right person or department.

The role will report to the Team Leader Medical -Customer Experience Center.

Key responsilibities 

• Provide timely and appropriate responses to clients and/or assign tickets to the right person or department.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 in liason with underwriters on 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;
• Maintain 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 by logging in interactions through CRM for traceability / visibility;
• Deliver on performance requirements as defined in the departments’ strategy map, balanced scorecard and Personal Scorecard with a view of increasing the NPS and Customer Satisfaction Index, and;
• Perform any other duties as may be assigned from time to time. 

Knowledge, experience and qualifications required

•  Diploma in Nursing or related medical field
• 3 – 5 years in a similar roleKnowledge of insurance regulatory requirements
• Knowledge of Britam products and services

Essential Competencies

• Learning and Researching: Rapidly learns new tasks and commits information to memory quickly; demonstrates an immediate understanding of newly presented information; gathers comprehensive information to support decision making at management level; learns from successes and failures and seeks colleague and customer feedback.
• Working with People: Shows respect for the views and contributions of other team members; shows empathy; listens, supports and cares for others; consults others and shares information and expertise with them; builds team spirit and reconciles conflict; adapts to the team and fits in well.
• Applying Expertise and Technology: Applies specialist and technical expertise; uses technology to achieve work objectives; develops job knowledge and expertise (theoretical and practical) through continual professional development; demonstrates an understanding of different organisational departments and functions.
• Delivering Results and Meeting Customer Expectations: Focuses on customer needs and satisfaction; exhibits high standards for quality and quantity; monitors and maintains own quality and productivity; works in a systematic, methodical and orderly way; consistently achieves projects goals.
• Following Instructions and Procedures: Follows procedures and policies; keeps to schedules; arrives punctually for work and meetings; demonstrates commitment to the organisation; complies with legal obligations and safety requirements of the role.
• Adhering to Principles and Values: Upholds ethics and values; demonstrates integrity; accepts diversity; display individual responsibility towards the community and the environment; models the organisational values during every day interactions.