Job Description
The Information Centre Care Agent is responsible for managing all incoming calls to the Old Mutual Medical emergency hotlines
KEY TASKS AND RESPONSIBILITIES
- Answer incoming telephone calls into the Call Center in a professional manner at all times.
- Working with providers and the Old Mutual Case management team to manage the admission and discharge process of Old Mutual Members.
- Managing requests for services from providers, intermediaries and clients, providing information on the Old Mutual provider network, available benefits per scheme policy and services and other routine information.
- Processing pre-authorization requests for outpatient services.
- Provides health information to customers via Old Mutual approved resources.
- Completes accurate and timely documentation of all services provided to callers.
- Escalate / liaise with claims/ care teams on any issues which require further consultation.
- In conjunction with Smart applications resolve card issues raised at the point of service.
- Attends all required training sessions and meetings.
- Normal information center duties. E.g. carrying out customer surveys, social media and email management.
- Performs all other tasks as assigned by the Information Center Manager, Case Management Supervisor, Medical Case Management Manager and/or Medical Claims Manager.
SKILLS AND COMPETENCIES
Competences
- Basic level of proficiency with Windows based applications such as MS Office, Excel, Word
- Proficient ability to analyse data and develop recommendations.
- Strong verbal and written communication skills.
- Maintains a professional/customer service focus at all times.
Qualifications & Requirements
- Availability to work any both day and night shifts
- 1+ years in Patient Customer Service Experience Preferred
- 1+ years Call Center experience Preferred
- 6+ months professional experience in an office setting using the telephone and computer as primary instruments to perform the job duties
- Knowledge of medical terminology/Coding (ICD10)
- Bachelor’s Degree or Diploma in Nursing
- Experience working in the Insurance industry preferred
- ACII or Other Insurance Certification Preferred
