Claims Administrator<\/p>\n
\tAccurate capturing of claims (80 claims per day minimum)
\n\tScanning and filing of paper claims
\n\tInform customers\/providers regarding unclear\/ incomplete invoices via appropriate methods (email and in writing\/ telephonically)
\n\tAnswer calls and resolve claim queries within determined SLA
\n\tTransfer customer calls to appropriate staff, where necessary
\n\tFollow-up on customer\/provider enquires not immediately resolved, within determined SLA\u2019s
\n\tComplete call logs and reports
\n\tFollow and adhere to claim processes, procedures and protocol
\n\tRecognize, document and alert the supervisor of trends with processing of claims
\n\tFocus on first call resolution as far as possible
\n\tExplain products and update customer details in computer system.
\n\tAnswer WhatsApp chats with customer requests within the determined SLA
\n\tConduct outbound calls as and when required to ensure client is informed and updated on the progress\/ status of the claim
\n\tImprove client service experience, create engaged clients, and facilitate organic growth
\n\tManages tasks allocated through omni-channel platforms including WhatsApp.
\n\tHandle complex and escalated client service issues
\n\tBuild\/maintain rapid channel of communication to client in case of service-related issues and events
\n\tRepresent the \u201cVoice of the Customer\u201d
\n\tCreate a culture of Customer\/Client Centricity
\n\tIdentify any potential errors or obstacles that may arise which might impact client experience and ensure this has been addressed and highlighted to Supervisor.
\n\tDemonstrate the Oneplan Values and Culture in all engagements with both clients and internal stakeholders.
\n\tLeverage team success to drive all initiatives and experiences with clients.
\n\tDisplay leadership through your actions by accepting responsibility for daily deliverables and ensuring turnaround times are achieved.
\n\tMaintain forward thinking and proactiveness by taking ownership of every interaction with the client and managing the client\u2019s queries from end-to-end to ensure a world class client service experience.
\n\tSupport cross-functional work areas targeted to resolve issues raised by clients.
\n\tProactively gather client feedback to optimise client experience<\/p>\n
Claims queries<\/p>\n
\tProvide accurate and efficient To log every call\/ query received\/made (Connex\/ notes OPA)
\n\tFollow-up on customer enquiries not immediately resolved, within determined SLA\u2019s.
\n\tComplete call logs and reports.
\n\tEducate clients on claims process<\/p>\n
Quality, Consistency and Compliance<\/p>\n
\tMaintain QA standard and ensure error rate does not exceed accepted variance
\n\tTimeous answering of chats within specified SLA (5 minutes)
\n\tEnsure adherence to standard operating procedures and demonstrate exceptional product knowledge in client engagements.
\n\tAll Email\/WhatsApp interactions must be returned to the queue at the end of every shift.
\n\tA Screenshot of your Connex interaction page needs to be sent to your line manager at the end of your shift. (Two screenshots, one with the interactions in your queue {If applicable} and one after you have transferred the interactions to the queue.)
\n\tClear Download History and Cache daily.
\n\tEnsure that your recycle bin is empty.
\n\tEnsure adherence to all relevant legislation and regulations as set out by the Company, FSCA, and the Financial Services industry<\/p>\n
Work Collaboratively\u00a0<\/p>\n
\tBuild a culture of respect and understanding across the organisation
\n\tRecognise outcomes which resulted from effective collaboration between teams
\n\tBuild cooperation and overcome barriers to information sharing, communication and collaboration across the organization
\n\tFacilitate opportunities to engage and collaborate with internal and external stakeholders to develop joint solutions.<\/p>\n
Minimum Academic, Professional Qualifications & Experience required for this position<\/p>\n
\tGrade 12 with English and a second language
\n\tRE5 (preferred)
\n\t1-2 years working experience in hospital\/medical aid or insurance claims processing would be highly advantageous
\n\tMeet FAIS fit and Proper requirements
\n\tIn-depth knowledge of Health\/ Pet Insurance<\/p>\n
Apply via company website ( N \/ A ) or<\/p>\n
eplan.mcidirecthire.com<\/p>\n
<\/p>\n","protected":false},"author":2,"featured_media":0,"template":"","meta":{"_promoted":"","_job_location":"","_application":"http:\/\/eplan.mcidirecthire.com","_company_name":"Oneplan Underwriting Managers (Pty) Ltd","_company_website":"http:\/\/N%20\/%20A","_company_tagline":"At Oneplan, we live by the philosophy that insurance should make life easier, not more complicated. That\u2019s why we offer simple and affordable insurance plans without sacrificing quality. We don\u2019t believe in sneaky clauses or conditions that come back to bite you when you need help the most.","_company_twitter":"","_company_video":"","_filled":0,"_featured":0,"_remote_position":0,"_job_salary":"","_job_salary_currency":"","_job_salary_unit":""},"job_listing_region":[11],"job-types":[12],"class_list":{"0":"post-11318","1":"job_listing","2":"type-job_listing","3":"status-expired","4":"hentry","5":"job_listing_region-gauteng","7":"job-type-full-time"},"jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job-listings\/11318","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job-listings"}],"about":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/types\/job_listing"}],"author":[{"embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/users\/2"}],"wp:attachment":[{"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/media?parent=11318"}],"wp:term":[{"taxonomy":"job_listing_region","embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job_listing_region?post=11318"},{"taxonomy":"job_listing_type","embeddable":true,"href":"https:\/\/jobs.dataaxisnode.com\/southafrica\/wp-json\/wp\/v2\/job-types?post=11318"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}