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Role Purpose:

Answer inbound or make outbound telephone calls, evaluate the caller’s assistance needs, take ownership of the problem and co-ordinate an appropriate solution to the problem presented using either internal or external resources.

Qualification Requirements:

• Minimum: Matric/Grade 12 or equivalent NQF4
• Advantageous: Short Term Insurance related qualification

Experience Requirements:

• 1 - 2 years experience in a call centre environment

Operational Responsibilities: 

• Claims are received telephonically, loaded by clients on V3 or clients requesting to be called back.
• Ensure that the claim is loaded as per clients requirements
• Ensure all changes or amendments made on any claims are to be updated on the claims notes
• Send claims to the insurance company for authorization
• Follow up with the insurance company should the claim not be authorized within 15 min to ensure fast and efficient authorization/resolution of all claims/queries.
• Sent the claim to the branch once its authorized for invoicing
• Ensure that the invoice from the branch is accurate and balances before accepting 
• Upon receipt, load all invoices received on DPS system by close of business daily for payment.
• Follow all account processes as clearly defined in the national deals/procedures
• Escalate complaints/possible complaints to the Team leader, Supervisor, Manager without delay
• Resolve clients queries efficiently and timeously
• Manage client expectations by communicating the workflow effective

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