Job Summary
To deliver exceptional customer service with unwavering consistency and high standards, we aim to uphold customer excellence and ensure access to high-quality, safe, effective, and cost-efficient healthcare for insured clients. At our 24-hour contact center, we handle customer inquiries and resolve product or service-related issues promptly and professionally.
Job Description
Responsibilities include promptly handling both incoming and outgoing calls while adhering to established contact center guidelines and etiquette, delivering professional solutions to customers within the specified turnaround times.
Guide insured members in effectively managing their benefits, selecting appropriate service providers, and addressing other related member benefit inquiries.
Addressing intricate customer challenges and delivering precise information to uphold high levels of customer satisfaction form the core of this role.
Managing technical components of client engagements, employing CRM tools, and maintaining a smooth, uninterrupted customer journey.
Respond promptly to client inquiries, including addressing phone calls and responding to emails, to provide information on membership eligibility, coverage details, approval status, benefit specifics, and case approvals or denials.
Issued medical pre-authorizations, undertakings, approvals, and declines in strict adherence to policy provisions, established authority limits, and designated turnaround times.
Acknowledge and record customer complaints or inquiries systematically for further processing and resolution.
Deliver timely resolutions to escalated customer and provider inquiries and complaints, ensuring clear communication of outcomes and comprehensive details regarding the medical product.
Escalate unresolved cases to the appropriate teams while ensuring thorough follow-up to achieve timely and satisfactory resolutions, thereby maintaining high levels of customer satisfaction.
Conduct outbound calls to engage with clients recently discharged from the hospital, gathering their service feedback and encouraging enrollment in the chronic disease management program (CDMP).
Provide members with tailored guidance on optimizing their benefits by suggesting affordable healthcare solutions and lower-cost alternatives, such as maternity care packages and chronic disease management programs.
Negotiate and secure reimbursement rates from external entities, including the Social Health Authority, ensuring timely recovery of funds.
Responsibilities include organizing and assigning call center staff schedules to ensure seamless 24-hour operations, factoring in employee rotation, total hours worked, and balanced workload distribution.
Proactively identifying service gaps and deploying corrective actions to address deficiencies is essential.
Maintain strict confidentiality of client information and ensure full compliance with the Data Protection Act.
Perform any additional official duties as directed by the line manager.
Proficiency in developing and implementing knowledge management systems is essential, along with the ability to curate, organize, and disseminate critical information effectively. Experience in creating and maintaining knowledge bases, intranets, or similar repositories is highly desirable. Strong analytical skills are required to assess knowledge gaps and ensure accurate, up-to-date content. Familiarity with content management systems and data governance principles is a must. The role involves collaborating with cross-functional teams to capture institutional knowledge and improve information accessibility. Excellent communication skills are necessary to train users and facilitate seamless knowledge sharing across the organization.
Enhance technical expertise by engaging in self-directed learning or structured training programs, while fulfilling all mandatory Continuous Professional Education requirements.
Facilitate the exchange of expertise and insights with colleagues and industry peers to foster collaborative learning and professional development.
By actively pursuing coaching, training, and consistent feedback, you will drive continuous improvement and elevate the quality of learning experiences.
Responsible for providing regular updates and insights to designated stakeholders, the incumbent will ensure accurate and timely communication of project progress, challenges, and milestones. This role requires maintaining clear documentation of performance metrics and deliverables while collaborating closely with cross-functional teams to align on objectives. Additionally, the position entails preparing detailed reports, analyzing data trends, and presenting findings to support informed decision-making. Proficiency in reporting tools and strong written and verbal communication skills are essential for success in this position.
Daily admissions reports are dispatched to clients, brokers, agents, and company human resource managers.
Prepare and assemble departmental reports on a daily, weekly, and monthly schedule, then submit them to management for review.
We are seeking a skilled professional to oversee and cultivate key stakeholder relationships, ensuring alignment with organizational objectives. The ideal candidate will possess strong interpersonal skills and the ability to foster trust and collaboration across diverse teams. Responsibilities include maintaining open communication channels, addressing concerns promptly, and identifying opportunities for mutual growth. A proven track record in relationship management, coupled with exceptional problem-solving abilities, is essential. Additionally, the role requires proficiency in conflict resolution and a keen understanding of stakeholder needs to drive long-term engagement and success.
Develop and nurture professional connections with colleagues, clients, brokers, agents, and human resource managers within the company.
A bachelor’s degree in a relevant field is required, along with three years of professional experience in a related industry. Proficiency in data analysis and project management tools is essential, as is the ability to work collaboratively in a team environment. Strong communication and problem-solving skills are also necessary to succeed in this role.
Proven expertise in customer relationship management (CRM) systems and the Microsoft Office Suite is required.
A Bachelor’s Degree or Diploma in Nursing (KRCHN), Clinical Medicine, Health Management, or a closely related discipline, along with a current and valid professional license, is required.
Professional Rewriting:
Candidates must possess a minimum of two years of hands-on clinical practice and at least three years of specialized case management experience.
Strong interpersonal competencies include superior verbal and written communication, empathy, negotiation expertise, teamwork, analytical problem-solving, adaptability to changing environments, and a steadfast commitment to customer satisfaction.
Demonstrates a comprehensive grasp of insurance policies, regulatory frameworks, compliance protocols, and industry standards.
Licensed by the pertinent statutory regulatory body within their specific medical discipline.
Seeking a candidate with a minimum of a bachelor’s degree in a relevant field, along with at least three years of professional experience in education. The ideal applicant will demonstrate expertise in curriculum development, instructional design, and student assessment. Strong communication and organizational skills are essential, as the role involves collaborating with diverse stakeholders, including faculty, administrators, and parents. Responsibilities include designing and implementing educational programs, evaluating student progress, and ensuring compliance with educational standards and regulations. Familiarity with educational technology and data analysis tools is preferred.
To qualify, applicants must hold a Further Education and Training Certificate (ETC) in Business, Commerce, and Management Studies.
To apply, please submit your application through the designated method.
To submit your application, please utilize the provided link(s) on the company’s official website.
Qualifications
BA/BSc/HND , Diploma
Experience Required
2 years
