Contact Centre Agent

Medshield Medical Scheme

Gauteng, South Africa

Permanent

Jul 16

Provide professional stakeholder support through attending to incoming calls from customers and respond to and resolve queries based on pre-defined standard operating procures, and refer complex queries, and provide customers with relevant information. Respond to inbound calls and emails, and provide a resolution based on pre-defined standard operating procedures for calls received through the Call Centre as per the SLAs or refer complex queries to Team Leader for assistance if necessary.Provide first call resolution where possible and refer or escalate complex queries to ensure continuous customer satisfaction. Provide members with product, services and membership information through the Scheme approved protocols.Identify and escalate priority issues and route calls to the appropriate department for resolution.Direct Members to the correct service provider when claims relate to authorizations or relevant Managed Care Providers.Record, investigate and resolve customer complaints and give feedback timeously.Print claims where necessary.Accurately update member information where necessary.Log the details of new members, for referral to Optivest.Document all call information according to Standard Operating Procedures.Complete all call logs and produce call reports.Research required information in order to address customer needs and queries, using available resources.Assist in identifying and adhering to fraud controls, risk prevention principles, sound governance and compliance processes, and tools to identify and manage risks.Support and provide evidence to all internal, external and ISO audit requirements.Assist in maintain quality risk management standards in line with the requirements from ISO9001:2015.Maintain and enforce all contact centre related Service Level Agreements to minimise business risk and ensure business continuity. Assist in identifying and adhering to fraud controls, risk prevention principles, sound governance and compliance processes, and tools to identify and manage risks.Support and provide evidence to all internal, external and ISO audit requirements.Assist in maintain quality risk management standards in line with the requirements from ISO9001:2015.Maintain and enforce all contact centre related Service Level Agreements to minimise business risk and ensure business continuity. Comply with all related Standard Operating Procedures in consultation with the Supervisor: Contact Centre to ensure business optimisation. Adhere to all relevant laws, policies and Standard Operating Procedures throughout the organisation.Build and maintain effective internal and external stakeholder relationships for the purpose of expectations management, knowledge sharing and integration. Liaise with members, brokers and healthcare professionals and 3rd parties delivering exceptional customer service.

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