Health Care-Jobs in United States

You will be responsible for providing excellent client services to a portfolio of clients of SIMEKA HEALTH by efficiently managing human capital queries, provide advice when required, claims and queries and all other medical scheme, gap cover, primary health insurance, loyalty related queries.

This role will be based in Sandton, Johannesburg.

• Provide an effective and efficient administrative channel between clients and service providers
• Must demonstrate a good understanding of all medical scheme options and benefits, primary care insurance, gap cover and loyalty programs
• Must provide, multiple query resolutions, ability to communicate in both written and a verbal professional manner
• Manage escalated admin and other requirements from service providers for clients
• Assists the Centralised Service Centre with in-bound and out-bound client calls
• Provide timeous feedback and resolution
• Assist clients with the application process, requirements and queries telephonically and / or via e-mail up to resolution. Frequent follow up with clients
• Assisting with new and existing quotes and advice where required

Keep ongoing records on internal CRM systems

• Matric
• Industry related Degree or Diploma (NQF level 5) is required
• Regulatory Examination RE5 is required
• 2 - 3 years' experience in a similar healthcare environment is required
• Full accreditation with the Council for Medical Schemes is advantageous
• Financial services industry experience would be advantageous

• Knowledge of industry regulations e.g., POPI and TCF
• Experience in managing customer relationships
• Experience in handling customer complaints
• Strong knowledge of medical scheme product and processes
• Strong knowledge of Internal and external processes including service level commitments
• Knowledge of relevant escalation channels
• Knowledge in managing and co-ordinating escalations from HR and other stakeholders
• Experience in managing customer relationships
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Proficient in both English and Afrikaans (verbal and written)

• Cultivates Innovation by creating new and better ways for the organisation to be successful
• Client Focus - Building strong customer relationships and delivering customer-centric solutions
• Drives Results - Consistently achieving results, even under tough circumstances
• Collaborates - Building partnerships and working collaboratively with others to meet shared objectives
• Resilience - Rebounding from setbacks and adversity when facing difficult situations.
• Communicates effectively - Contributing independently
• Decision quality - Contributing independently
• Action orientated - Contributing independently
• Optimises work processes - Contributing independently