Simeka: Inhouse Service Healthcare Consultant (Bellville)

Simeka: Inhouse Service Healthcare Consultant (Bellville)

Date: 11 Sep 2024

Location: Bellville, Western Cape, ZA

Who are we?

Sanlam Corporate forms part of the Sanlam Group which offers retail and corporate life insurance, health and investment products in South Africa. Our vision is to be the preferred partner to Corporate and Public Sector by providing an awesome client experience and comprehensive solutions that enable the financial resilience and prosperity of those entities and their employees.

We tap into over 100 years of expertise to provide cost-effective Employee Benefits and Healthcare Solutions that enable financial confidence for our members. We enable our clients to make better retirement and risk decisions today through determined and passionate thought leadership and best-in-class people, innovative products and proven processes all designed to help people live a better life tomorrow.

We believe in creating and cultivating a positive, energised working environment that gives every individual the opportunity to achieve success by embracing diversity and growing our talent.

What will you do?

The incumbent is responsible for providing excellent client services to a portfolio of clients by efficiently managing human capital queries, any claims and all other medical scheme, gap cover, primary health insurance and loyalty related queries.

Key Responsibilities

• Provide an effective and efficient administrative channel between clients and service providers.
• Demonstrate a good understanding of all medical scheme options and benefits, primary care insurance, gap cover and loyalty programs.
• Provide multiple query resolutions and communicate in both written and verbal professional manner.
• Manage escalated admin and other requirements from service providers for clients.
• Assist with Call Centre in-bound and out-bound client calls.
• Assist with email inboxes and query logging to the CRM system as required.
• Provide timeous feedback and resolution on queries.
• Keep ongoing records on internal CRM systems.
• Assist clients with the application process and queries telephonically and/or via email up to resolution.
• Frequent follow-up with clients on open and outstanding requirements.

Qualification and Experience

• Regulatory Examination RE5 is required
• Full Accreditation with the Council for Medical Schemes is advantageous.
• Industry related Degree or Diploma (NQF level 5) is required.
• 2 - 3 years’ experience in a similar healthcare environment with Intermediary services is required.

Knowledge and Skills

• Knowledge of industry regulations e.g., POPI and TCF
• Experience in managing customer relationships
• Experience in handling customer complaints
• Strong knowledge of medical scheme product and processes.
• Strong knowledge of Internal and external processes including service level commitments.
• Knowledge of relevant escalation channels.
• Knowledge in managing and coordinating escalations from HR and other stakeholders.
• Proficiency in Microsoft Office (Word, Excel, Outlook)
• Brokertools experience advantageous.

Core Competencies

• Cultivates Innovation by creating new and better ways for the organisation to be successful.
• Client Focus - Building strong customer relationships and delivering customer-centric solutions.
• Drives Results - Consistently achieving results and meets deadlines, even under tough circumstances.
• Collaborates - Building partnerships and working collaboratively with others to meet shared objectives.
• Resilience - Rebounding from setbacks and adversity when facing difficult situations.

Our commitment to transformation

The Sanlam Group is committed to achieving transformation and embraces diversity. This commitment is what drives us to achieve a diverse, inclusive and equitable workplace as we believe that these are key components to ensuring a thriving and sustainable business in South Africa. The Group's Employment Equity plan and targets will be considered as part of the selection process.