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  • Posted: Nov 24, 2021
    Deadline: Not specified
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  • Kaelo Engage is a content marketing agency specialising in creating socially responsible content. Whereas a traditional public relations agency may only focus on issuing press releases, we leverage our in-depth experience and team’s passion to profile your sustainability initiatives through meaningful and relevant content creation in print, digital, br...
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    Clinical Call Centre Agent

    Job Description

    •        Log into the clinical Call centre daily on time
    •        Interview members and Drs upon calling
    •        Educate members on benefits such as Member Management Assistance Programme
    •        Educate  member on the difference between GP consultation  and Virtual consultation benefits
    •        Advise members on the effects of further management and refer to correct specialist
    •        Refer member for  nurse consultation at a contracted pharmacy for minor ailments such as temperature, fever etc
    •        Load valid Dr’s consultation events on valid request
    •        Activate extra benefits for deserving members such as more than the required benefit 
    •        Understand the benefit of different medical Insurance and Medical Aid differently
    •        Access different systems to verify membership and plan type
    •        Load virtual consultation and allocate time with the Chief Medical Officer
    •        Respond to clinical enquiries from general call centre
    •        Understand claims benefits and be able to explain to member
    •        Maintain Service Level agreements on call volume
    •        Load specialist auth numbers from the Case managers email address.
    •        Basic understanding of Chronic Disease List
    •        Ability to refer members to the correct department
    •        Be comfortable to discuss HIV as an extra condition on enquiry
    •        Understand the access to benefits  on different plan and policy options

     

    KEY OUTCOMES

    • Maintain Service levels above 85%
    • Be willing to assist the Patient managers   with in-coming calls .
    • Ability to maintain confidentiality as dealing with client clinical information
    • Continuous support of members in need of help and
    • Increase member satisfaction and understanding of benefits
    • Ability to work well under pressure
    • Be a team player 
    • Reliable, dedicated and professional

    Qualifications
    SPECIAL REQUIREMENTS

    • Experience in the medical aid Industry
    • Confidence t deal with DR’s and members

     

    PERSON DETAILS : WORK EXPERIENCE

    REQUIRED

    • Knowledge of the medical terminology
    • Work in the medical aid industry
    • Call centre experience will be an advantage

     

    PREFERRED

    EDUCATION : QUALIFICATIONS : ACCREDITATIONS WITH PROFESSIONAL BODY

    REQUIRED

    •        An enrolled nurse with an enrolled Certificate /or a Registered Nurse 
    •        Registration with the SANC
    •        Knowledge and experience of the medical industry
    •        Ability to speak more than 1 African language will be an advantage
    •        Basic understanding of the ICD 10 codes
    •        Ability to show empathy  

     

    PREFERRED

    TECHNICAL SKILLS OR KNOWLEDGE

    REQUIRED

    • Attention to detail
    • Computer literate
    • Microsoft Access
    • Clinical discretion

    PREFERRED

    Computer literacy.

    Additional Information

    •      Accountability
    •      Action orientated
    •      Communication
    •      Business writing skills
    •      Manages complexity
    •      Problem solving skills
    •      Encourages engagement
    •      Planning and organisation
    •      Resilient and adaptive
    •      Systems thinking and connecting ability
    •      Purpose driven
    •      Significance and values orientated

    Method of Application

    Interested and qualified? Go to Kaelo Engage on jobs.smartrecruiters.com to apply

    Note: Never pay for any training, certificate, assessment, or testing to the recruiter.

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