PURPOSE:
To manage clients within the medical business to achieve efficiency in service delivery through various activities that enhance the customer experience.
PRIMARY RESPONSIBILITIES:
SERVICE DELIVERY MANAGEMENT
- Coordinate dispatch of renewal notices and confirm renewals through active client engagement.
- Conduct scheme performance and service review meetings with clients to identify and address service gaps;
- Train scheme members on awareness on their policy and best utilization practices such as hospital access, benefit management etc.;
- Educate scheme members on Wellness program to enhance healthy living through medical camps and health talks – involves evaluation of common ailments claimed in a scheme;
- Ensure timely and efficient follow up on questions, issues, reimbursements approvals and other ad-hoc points of communication between clients and CIC.
- Sharing of reimbursements payments and declines.
- Coordinate consistent updates to clients on phone and email on any changes or improvements affecting their policy.
- Receive and transmit all member addition and deletion instructions to the Medical Underwriting team.
- Receive and transmit all invoices and credit notes from CIC to the client.
- Sharing of membership numbers and training members on Virtual access.
- Share monthly scheme Funds reports by the 10th day of every Monthly and ensure timely collection.
- Share quarterly scheme utilization reports and plan in consultation with the contact persons for quarterly performance review meetings.
- Follow up on historical and current debts.
- Update the contact person on daily admission updates and death notifications.
GENERIC DUTIES
- Identify process improvement areas and raise with CIC management team for implementation.
AUDIT, COMPLIANCE AND RISK MANAGEMENT
- Strict adherence to all regulations, statutes, standards, practices and all internal processes and procedures as per the relevant manuals and comply with all relevant external legislation and regulations with regard to Compliance requirements.
- Ensure that as a staff you actively contribute to the department/division attaining a “good” rating in both internal and external audit by performing your role to the required standards and adhering to all internal processes and procedures as per relevant manuals, policies and regulations of the Company.
- Ensure that all risk management requirements within your remit are addressed and where necessary escalated through the available defined channels
Key Skills, Knowledge, Experience and Behavioural Competencies
Academic and Professional Requirements
Education
- Bachelor’s Degree in a relevant field,
Experience Required:
- Minimum of three (3) years’ relevant experience in a similar position.
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