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
Key
Responsibilities:
- Delivery exceptional customer experience in all
interactions on call and email by maintaining highest level of
professionalism.
- Review and approve dental 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.
- Educate insured members about their dental
benefits, coverage limitations, and preventive care options to promote
health awareness.
- Identify appropriate specialists, services, or
community resources that can contribute to the member’s overall health and
well-being
- Manage urgent or critical cases promptly,
coordinating immediate interventions and connecting with emergency
services as needed.
- Issuing preauthorization approvals for both out
and in patient cases.
- Keep a clear complaint tracker and ensure timely
resolution of all complaints and escalations.
- Respond to potential/existing customer
intermediaries’ inquiries by providing and/or clarifying with the desired
information.
- Proficiency in optical terminology and eyecare
processes.
- Proficiency in dental data analysis and
- Identify appropriate specialists, services, or
community resources that can contribute to the member’s overall health and
well-being. .
- Proficiency in medical terminology.
- Resolves complaints by clarifying issues and
exploring and alternative solutions, implementing solutions, and
escalating unresolved complaints. viii. Evaluate the optical healthcare
needs, visual history, and current condition of members to develop a clear
understanding of their eyecare 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.
Qualifications
- Graduate from a recognized university
- Medical professionals have an added advantage.
- Proficient in the use of Microsoft Office suite
and packages
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 Job Ref.
No.22/26 and Position by 6th February 2026
