Latest Vacancies at Oneplan Underwriting Managers (Pty) Ltd

Main purpose of the job

• Provides support to clients relating to claims and claim queries.
• Project a professional company image through customer/provider interaction.

Claims Capturing

• Accurate capturing of claims (80 claims per day minimum)
• Scanning and filing of paper claims
• Inform customers/providers regarding unclear/ incomplete invoices via appropriate methods (email and in writing/ telephonically)
• Answer calls and resolve claim queries within determined SLA
• Transfer customer calls to appropriate staff, where necessary
• Follow-up on customer/provider enquires not immediately resolved, within determined SLA’s
• Complete call logs and reports
• Follow and adhere to claim processes, procedures and protocol
• Recognize, document and alert the supervisor of trends with processing of claims
• Focus on first call resolution as far as possible
• Explain products and update customer details in computer system.
• Answer WhatsApp chats with customer requests within the determined SLA
• Conduct outbound calls as and when required to ensure client is informed and updated on the progress/ status of the claim
• Improve client service experience, create engaged clients, and facilitate organic growth
• Manages tasks allocated through omni-channel platforms including WhatsApp.
• Handle complex and escalated client service issues
• Build/maintain rapid channel of communication to client in case of service-related issues and events
• Represent the “Voice of the Customer”
• Create a culture of Customer/Client Centricity
• Identify any potential errors or obstacles that may arise which might impact client experience and ensure this has been addressed and highlighted to Supervisor.
• Demonstrate the Oneplan Values and Culture in all engagements with both clients and internal stakeholders.
• Leverage team success to drive all initiatives and experiences with clients.
• Display leadership through your actions by accepting responsibility for daily deliverables and ensuring turnaround times are achieved.
• Maintain forward thinking and proactiveness by taking ownership of every interaction with the client and managing the client’s queries from end-to-end to ensure a world class client service experience.
• Support cross functional work areas targeted to resolve issues raised by clients.
• Proactively gather client feedback to optimize client experience

Claims Queries;

• Provide accurate and efficient To log every call/ query received / made (OTRS/ notes OPA)
• Follow-up on customer enquires not immediately resolved, within determined SLA’s.
• Complete call logs and reports.
• Educate clients on claims process.

Quality, Consistency and Compliance

• Maintain QA standard and ensure error rate does not exceed accepted variance
• Timeous answering of chats within specified SLA (5 minutes)
• Ensure adherence to standard operating procedures and demonstrate exceptional product knowledge in client engagements.
• Ensure adherence to all relevant legislation and regulations as set out by the Company, FSCA, and the Financial Services industry

Work collaboratively;

• Build a culture of respect and understanding across the organisation
• Recognise outcomes which resulted from effective collaboration between teams
• Build cooperation and overcome barriers to information sharing, communication, and collaboration across the organization
• Facilitate opportunities to engage and collaborate with internal and external stakeholders to develop joint solutions

Self Management;

• Follow through to ensure that personal quality and productivity standards are consistently and accurately maintained
• Demonstrate consistent application of internal procedures
• Plan and prioritise, demonstrating abilities to manage competing demands
• Demonstrate abilities to anticipate and manage change
• Demonstrate flexibility in balancing achievement of own objectives with abilities to understand and respond to organizational needs

Requirements

Minimum Academic, Professional Qualifications & Experience required for this position

• Grade 12 with English and a second language
• RE5 (preferred)
• 1-2 years working experience in hospital/medical aid or insurance claims processing would be highly advantageous
• Meet FAIS fit and Proper requirements
• In-depth knowledge of Pet Insurance/Industry

Functional Competencies;

• Literacy – Have excellent reading, writing and interpersonal skills
• Pc Literacy – In-depth knowledge of Word, excel, email and Internet
• Ability to respond according to TAT
• Client relationship management
• Maximise service performance
• Query resolution
• Build & develop client centric capabilities
• Deliver on client expectations
• Knowledge Sharing
• Driving excellence through client experience

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Evaluating Call Quality 

• Assist operations in tracking, documenting, and reporting on quality levels
• Analyse and investigate calls to ensure resolution in accordance with company guidelines and external regulatory requirements
• Develop or update company procedures to ensure capture, investigation, and proper documentation of complaints
• Monitor risk-management procedures, and maintain problem logs for identifying and reporting issues to management and product development
• Provide training and support to quality assurance team that includes systems, policies, procedures, and core processes
• Interpret, build upon, and comply with company quality assurance standards
• Carefully maintain complaint and nonconformance processing through records and tracking systems, including root cause and corrective actions
• Document quality assurance activities with internal reporting and audits
• Participate in the design of the call monitoring framework, quality standards and the associated checklists.
• Conduct audits ensuring compliance with performance standards and outcomes (e.g. quality, compliance of process and accuracy)
• Create reports on performance results (individual and team level) to provide to management for the development and action plans for agents.
• Prepare and analyse quality reports for management staff review.
• Provide feedback and input into enhancements of processes, training and systems based on trends.
• If required, assist with the coaching of agents based on findings.
• If required, may answer phone calls, respond to written inquiries, and handle “escalated” issues in support of work performed by agent.

Quality, Consistency and Compliance

• Maintain QA standard and ensure error rate does not exceed accepted variance
• Ensure adherence to standard operating procedures and demonstrate exceptional product knowledge in engagements.
• Ensure adherence to all relevant legislation and regulations as set out by the Company, FSCA, and the Financial Services industry

Work collaboratively

• Build a culture of respect and understanding across the organisation
• Recognise outcomes which resulted from effective collaboration between teams
• Build cooperation and overcome barriers to information sharing, communication, and collaboration across the organisation
• Facilitate opportunities to engage and collaborate with internal and external stakeholders to develop joint solutions

Self-Management:

• Follow through to ensure that personal quality and productivity standards are consistently and accurately maintained
• Demonstrate consistent application of internal procedures
• Plan and prioritise, demonstrating abilities to manage competing demands
• Demonstrate abilities to anticipate and manage change
• Demonstrate flexibility in balancing achievement of own objectives with abilities to understand and respond to organizational needs 

Requirements:

Minimum Academic, Professional Qualifications & Experience required for this position

• Grade 12 with English and a second language
• Relevant qualification will be advantageous
• 1 – 2 years’ experience in a Quality Assurance environment or Call Centre Sales environment preferred 
• Meets FAIS Fit & Proper requirements as per legislation – RE5 (essential)

Functional Competencies

• Excellent listening and administrative skills
• Proficient in the use of MS Office
• Ability to assess calls and provide insight and value-added feedback to management
• Ability to understand SOP’S and ensure adherence to internal processes at all times
• Knowledge of QA metrics, Variance reports and calibration sessions
• Accuracy and attention to detail
• Ability to meet deadlines

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Sales & Marketing 

• Develop and implement marketing plans that will out perform competitor strategies.
• Continuously analyze competitor strategies and ensure knowledge is current on competitor activity, new products and services.
• Promote and market the Oneplan brand and its solutions to brokers to influence the sale of in-house products.
• Partner with and identify the needs of brokers and provide the necessary support.
• Negotiate with intermediaries regarding the level of business and servicing requirements.
• Promote Oneplan solutions through marketing presentations and training.
• Establish and maintain business relationships in order to grow market share with existing brokers.
• Ensure the business's processes and policies are adhered to in the management of relationships at all times, and to represent the company in a professional, business-like manner.
• Efficiently apply technology and update investment knowledge in the business.
• Prepare quotations, receive and check new business applications.
• Arrange premium payment facilities and open new facilities as required.
• Initiate and manage marketing drives to secure profitable, quality new business from brokers.
• Maintain productive levels with acceptable quality of business and manage the risk of such business.
• Manage administration related to missed payments, broker contract applications, after sales service, etc.
• Deliver training to brokers to ensure their understanding of Oneplan products and services where necessary.
• Continuously monitor turnaround times and quality standards and resolve issues speedily to enhance client service delivery.
• Drive client service delivery goal achievement in line with predefined standards in order to ensure that clients receive appropriate advice and after sales service.
• Manage client query processes and ensure that queries are tracked, accurately resolved and used as a mechanism to improve client service and business processes.
• Provide regular reports on delivery of services against agreed service standards and in terms of overall client targets.
• Provide authoritative, expertise and advice to clients and stakeholders.
• Build and maintain relationships with clients and internal and external stakeholders.
• Contribute to the process of developing client service standards in order to ensure clients receive clear and accurate information and are kept informed at all times.
• Manage the delivery on service level agreements made with clients and internal and external stakeholders in order to ensure that client expectations are managed.
• Make recommendations to improve client service and fair treatment of clients within area of responsibility.
• Participate and contribute to a culture which builds rewarding relationships, facilitates feedback and provides exceptional client service.
• Build strong relationships through providing specialist know-how and leadership to others, expressing positive expectations.
• Continuously develop own expertise in terms of industry and subject matter development and application thereof in an area of specialization.
• Positively influence and manage change and offer specialist support where required.
• Contribute to continuous innovation through the development, sharing and implementation of new ideas and involvement of colleagues and staff.
• Participate and contribute to a culture of work centric thinking, productivity, service delivery and quality management.
• Take ownership for driving career development.
• Research and monitor financial market trends to ensure that plans are relevant, effective and to identify any necessary updates.
• Prepare, interpret and present client financial performance and other relevant information so enhance client understanding and facilitate decision-making.
• Conduct client financial needs analysis in order to develop and implement a customized financial plan to achieve clients' financial goals.

Account Management:

• Meet goals for volume and value of quality new business quoted and written within company Management of own portfolio.
• Recommend or implement changes to improve productivity, profitability, growth and the quality of assigned book of business.
• Service, grow and maintain renewal policies.
• Confirm rating and cover on endorsements requested.
• Review segment profit/growth results and trends to recommend and implement action plans to produce profitable underwriting results.
• Ensure that all premiums are received and up to date on all accounts in portfolio.
• In collaboration with credit control review and discuss all outstanding premiums and arrears with Brokers on a monthly basis.
• Underwriting/Risk Analysis: Analyze qualitative and quantitative data prepared by brokers to provide approval for risk selection and acceptance, coverage and price.
• Recommend creative alternatives in regards to rating plans, coverage and payment plans.
• Decline unsuitable risks.
• Ensure that policy transactions (quotes, new business, endorsements, renewals, post loss, cancellations) are issued and changes recorded accurately and in a timely manner by rating and/or capturing transactions to the core business system.
• Ensure reinsurance is in place, where applicable

Process Adherence:

• Ability to manage their own workload.
• Always comply with company policy and procedures 
• Pro-active approach to process improvement.
• Any additional responsibilities as required from time to time

Work collaboratively

• Build a culture of respect and understanding across the organisation
• Recognise outcomes which resulted from effective collaboration between teams
• Build cooperation and overcome barriers to information sharing, communication and collaboration across the organization
• Facilitate opportunities to engage and collaborate with internal and external stakeholders to develop joint solutions

Self-Management

• Follow through to ensure that personal quality and productivity standards are consistently and accurately maintained
• Demonstrate consistent application of internal procedures
• Plan and prioritise, demonstrating abilities to manage competing demands
• Demonstrate abilities to anticipate and manage change
• Demonstrate flexibility in balancing achievement of own objectives with abilities to understand and respond to organizational needs

Requirements:

Minimum Academic, Professional Qualifications & Experience required for this position

• Grade 12/NQF 4 equivalent qualification.
• B.Com/Higher Diploma or equivalent business related qualification(Advantageous)
• Meets FAIS Fit & Proper requirements as per legislation – RE5 (essential)
• Valid driver's license and own transport.
• Product knowledge and competitor intelligence.
• 3-5 years experience in Broker Account Management environment (Essential)
• Experience In Financial Services Industry (Essential)

Functional Competencies

• PC Literacy- word, excel, email and internet
• Ability to communicate effectively and clearly in writing and verbally, including drafting correspondence and documents
• Ability to work independently
• Function under pressure and ability to work under strict deadlines
• Adaptability
• Strong analytical and problem-solving skills
• Detail-oriented with excellent data entry skills
• Thorough understanding of the insurance industry and its products