Care Centre Officer- Medical

JOB OVERVIEW:

The main duty of a Contact Centre Agent is to respond to communication inquiries / complaints raised by Stakeholders as per the standard procedures. The incumbent is also responsible to ensure that all cases are responded within predetermined time scales and are dealt with the highest standards of customer service. will also document details of all cases and actions taken, in order to make further follow-ups and corrective action as required. Contact Centre Agent will correspond with Care Centre Management accordingly and comply to provide a customer-oriented service at all times.

KEY RESPONSIBILITIES/what you do:

• Claims Pre-certification and Adjudication with compliance to established Policy Guidelines as well as managing & providing overall guidance about Medical Cases review & authorization over Phone.
• Responding to queries regarding cover, claims, hospitalization, complaints
• Commit to the department`s service standards across phone, email, live chat, and customer experience metrics such as customer satisfaction and NPS. case
• se AI insights to empower the team, providing purpose and direction while fostering a collaborative environment.
• Develop extensive and sound product knowledge to provide timely and accurate information to our clients.
• Utilize AI-driven feedback mechanisms to develop people, provide constructive feedback, and care for employee wellbeing.

Customer & Market Excellence: Strive for excellence at every touch point with the customer Foster state-of-art technical/operational knowledge and strive for continuous simplification Be the benchmark

Collaborative Leadership: Empower the team and provide purpose and direction Develop people, provide feedback and care to employee wellbeing Collaborate and exchange best practice.

Entrepreneurship: Act on opportunities, anticipate trends, take risk, and promote a culture that allows for honest failure Take ownership and responsibility Embrace innovation and a culture that allows to make decisions without fear of retribution.

Trust: Act with integrity, honor commitments, tell the truth Foster diversity and inclusiveness Act transparently and promote corporate social responsibility.

REQUIREMENTS/ what you bring: Medical background is a must. 6 months - 3 years of experience. Experience in a customer facing role is beneficial. Insurance experience is a plus. Previous experience in Call Centre environment would be beneficial. Experience working in pressurized environment with tight deadlines. Strong Knowledge of Microsoft Office (Excel, Word) High level of fluency in English is a must. Must be fully flexible to work rotating shift patterns including shift work, nights, and weekend. Experience in a customer-facing role, ideally with exposure to AI-enhanced service platforms.