Job Title: Care Excellence Executive
Hiring Organization: Jubilee
Insurance
Location – Locality: Nairobi
Location – Region: Kenya
Industry: Insurance
Job Type: Full
Time
Salary: KES
Competitive
Date Posted: 01/16/2024
Job Ref. No: JHIL104
Role Purpose
The job
holder will be responsible for attending to intermediary, customer, and
providers queries by determining their requirements, answering to these
inquiries, resolving problems, and fulfilling customer’s requests. The holder
will be required to ensure excellence in all customer interaction and offer
memorable experiences.
Main
Responsibilities
Operational
- Delivery
exceptional customer experience in all interactions on call and email by
maintaining highest level of professionalism.
- Manage
urgent or critical cases promptly, coordinating immediate interventions
and connecting with emergency services as needed.
- Issuing
preauthorization approvals for all outpatient, dental, optical, and
inpatient cases.
- Keep
a clear complaint tracker and ensure timely resolution of all complaints
and escalations.
- Respond
to potential/existing customer and intermediaries’ inquiries by providing
and/or clarifying with the desired information.
- Identify
appropriate specialists, services, or community resources that can
contribute to the member’s overall health and well-being.
- Resolves
complaints by clarifying issues and exploring answers and alternative
solutions, implementing solutions, and escalating unresolved complaints.
- Evaluate
the healthcare needs, history, and current condition of members to develop
a clear understanding of their healthcare requirements.
- Ensure
strict process compliance in line with the business lines objective.
- Selling
additional products by recognizing opportunities to cross-sell or up-sell
new benefits.
- Maintain
and improve quality results by adhering to standards and guidelines,
recommending improved procedures.
- Generate
reports on the various engagements and feedback collected. Contribute to
quality improvement initiatives by providing insights and feedback to
enhance care processes and outcomes.
- Collaborate
with dental professionals, specialists, and providers to coordinate and
facilitate comprehensive dental care for insured members.
- Review
all treatment plans, ensuring they align with medical guidelines, member
needs, and insurance coverage.
- Engage
with insured members to explain treatment options, address concerns, and
support them throughout their healthcare journey.
- Identify
appropriate specialists, services, or community resources that can
contribute to the member’s overall health and well-being.
Key
Competencies
- Empathy
skills
- Listening
skills
- Verbal
communication
- Adaptability
- Attention
to detail.
- Good
Interpersonal relationships
- Ability
to multi-task
- Proficiency
in optical terminology and eyecare processes.
- Proficiency
in dental data analysis and interpretation.
- Proficiency
in medical terminology.
Qualifications
- Graduate
from a recognized university
- Medical
professionals have an added advantage.
- Proficient
in the use of Microsoft Office suite and package
Relevant
Experience
- Minimum
of 1 year experience in a Call Centre environment.
How To
Apply
If you
are qualified and seeking an exciting new challenge, please apply via Recruitment@jubileekenya.com quoting
the Job Reference Number and Position by 21st
January 2024 Only shortlisted candidates will be
contacted.
