Job Openings at Medical Administrators Kenya Limited

 Reports to    Senior Manager – Customer excellence   

Principle Role   

The  MIS Analyst will conduct full operations lifecycle activities to include requirements analysis and design, develop analysis and reporting capabilities, and continuously monitor performance and quality control plans to identify improvement areas.

KEY RESPONSIBILITIES AND DELIVERABLES:

Essential Responsibilities

• Provide weekly, monthly and annual forecasts and resource planning in order to support the department performance objectives
• Interpret data, analyze results using statistical techniques and provide ongoing reports
• Identify, analyze, and interpret trends or patterns in complex data sets
• Generate and distribute management reports (periodic and ad hoc) in an accurate and timely manner
• Develop and implement data collection systems and other strategies that optimize statistical efficiency and data quality
• Acquire data from primary or secondary data sources and maintain databases/data systems
• Review system reports and performance indicators to locate improvement opportunities on process, service and resource planning
• Work closely with supervisors and management to prioritize business and information needs
• Defining inputs for ad hoc Business Case justification
• Analyze business information to identify process improvements for increasing business efficiency and effectiveness
• Participate in cross-functional meetings to resolve recurring customer issues
• Link to IT & other source departments on system issues relating to reporting
• Ensure there is a recovery plan on data relating to customer support operations
• Manage the information systems through defining data entry & extraction points
• Define system access matrixes for Team as per security and IT Policies
• Provide customer support and assistance in issue troubleshooting and resolution

QUALIFICATION AND EXPERIENCE

• A good understanding of customer support resources, forecasting and planning techniques and how their successful deployment can deliver step change in the customer experience and operation efficiency
• 2 years’ experience in a large 24/7 and diverse customer support operation, preferably in ICT sector
• Experience with Workforce Management technologies, preferably within a multi-site or multi-skilled, complex telephony environment
• Recent and demonstrable experience in data analysis, reporting and planning
• Technical expertise regarding data models, database design development, data mining and segmentation techniques
• Knowledge of statistics and experience using statistical packages for analyzing large datasets (Excel, SPSS, SAS etc.)
• Added advantage - reporting packages (Business Objects etc.), databases (SQL etc.), programming (XML, JavaScript, or ETL frameworks)
• Strong analytical skills with the ability to collect, organize, analyze, and disseminate significant amounts of information with attention to detail and accuracy
• Adept at queries, report writing and presenting findings
• BS in Mathematics, Economics, Computer Science, Information Management or Statistics

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Reports to    Team Leader  – Customer excellence  

Principle Role   

The CSE is responsible for providing professional and quality customer service both internally and externally.  The CSR will be responsible for customer support at the designated touch point.
The CSE must get full understanding of customer's enquiry and attend to the customer, solving the issue and log it on CMT and all other systems as need be.

• If the issue is resolved, the CSE ensures that customer is satisfied and confirms the customers contact details.
• If issue can't be resolved while on call, it is escalated by the CSE to the CE leader and followed up through the proper channels until resolution
• Customers should be clearly directed/guided on what to do.

KEY RESPONSIBILITIES AND DELIVERABLES:

• Provide one-stop customer support for all MAKL services by responding to customer contacts within defined SLAs
• Resolving all complaints, concerns and issues in a timely and diplomatic manner. Conduct activities in a professional manner
• Demonstrate knowledge of MAKL service standards or service level agreements.
• Demonstrating knowledge of impact of providing professional service to Customers.
• Understanding the importance and impact of first call resolution (FCR).
• Working with the CE leader on performance improvement as an individual and with the team as a whole.
• Ensuring complaints/concerns are resolved or escalated in a timely manner.
• Providing timely notifications to management of negative trends, urgency of issue, or extent of required follow up.
• Determining when a problem requires action from higher level of authority.
• Participate in regular team meetings.
• Educate customers about terminology, features and benefits of products in order to improve customer education and satisfaction.
• Updating client comments, complaints, reports and compliments on all relevant MAKL Systems.
• The job holder will be expected to identify and highlight to the CE leader, all emerging service issues of general or unique nature; that may require support, upgrade or restructuring of Medical services in order to meet customer needs.
• Resolve customer query on first contact and keep the promise of query/problem resolution for escalated cases.
• Take full ownership of customer cases that land and handover unresolved cases at end of day
• Complete Welcome Calls to engage new Customers in customer experience
• Confirm client information and update on existing database.
• Enhance customer loyalty and upsell accordingly.
• Record information on reason for contact – service request, enquiry or complaints.
• Actively participate n process improvement meetings as required. Attend team briefs {BOD/EOD} and QA calibrations sessions when called on.

QUALIFICATION AND EXPERIENCE

• Previous customer service experience, particularly with written forms of customer service.
• Excellent written communication skills: grammar, sentence structure, and spelling.
• Computer literate with ability to learn new applications quickly.
• Positive attitude with proven ability to work well with teams.
• Strong typing skills.
• Strong customer service,
• Previous call center or direct customer-facing experience.
• Strong understanding of social media channels.
• Team player with a positive attitude.
• Able to work under pressure in a fast-paced, high-volume environment.
• Ability to remain polite with angry and uncooperative customers.
• Available to work days, nights, and weekends and overtime

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Reports to    Team Leader  – Medical Operations   
Level    Executive Level – 2 years’ experience in a busy hospital   

Principle Role    

A clinical officer who will be able to apply their medical expertise in Medical insurance claims processing

KEY RESPONSIBILITIES AND DELIVERABLES:

• Responding to pending issues from service providers.
• Ensuring set targets are met and TAT observed and achieved.
• Vetting and processing of reimbursements.
• Process Company’s response to claims/Preauth
• Monitoring inventory records.
• Coordination of claims/Preauth processing.
• Follow up with providers for bills, discrepancies in bills and other information that is holding up processing.
• Respond to client enquiries on claims through e-mail, phone or directly.
• Resolve problems related to claims/preauth by liaising with Medical service Providers panel.
• Clinical officer has to be well equipped with the latest trends and technologies used.
• Expert in drafting the process in and out.
• Smart in tackling various types of clients.
• Supervising the educational material provided to patients by clinical officer.
• Evaluating the Preparation and delivery of claims presentations by clinical officer.
• Provide cover for colleagues in their absence, ensuring that the handling of their Preauth/claims is kept up to date.
• Liaising with other healthcare personnel for efficient delivery of patient care.
• Responding to mails, calls, and medical related queries on social media platform.
• Any other duties as may be assigned.

QUALIFICATION AND EXPERIENCE

Minimum Qualifications and Experience Requirements

• Diploma clinical medicine and surgery.
• Registered and licensed by the relevant medical body.
• Minimum of 3 years of experience in relevant medical field
• Experience in the Health Insurance industry will provide an added advantage
• Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• Knowledge and experience in reading, analyzing, and interpreting reports and support procedures.
• Proficiency in MS Office - specifically Excel, Access, Word, PowerPoint.
• Ability to effectively present information and respond to questions from management, peers and customers.
• Self-driven, customer centric , team player and good communication Skills
• Willingness to go the extra mile.