Client Relations Agent – Maputo
@EP Management Consultant posted 4 months ago Email JobJob Detail
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Job ID 6191
Job Description
To achieve, by means of effective actions and assistance to management, corporate groups, brokers and members, Company’s objectives in respect of effective productivity and client services.
Ensure effective quality, quantity, and turnaround control of all CR processes in consistence with company governance principles, protocols, rules and in line with local legislation.
Responsibilities:
Deal with different types of queries:
- Benefit queries;
- Membership (Groups, Private – Data capturing of new applications, add and terminate memberships and their dependents;
- Request suspensions and update contact details.);
- Claims queries and statements;
- Digital platforms (HR portal, mobile application, member self-help portal);
- Authorizations (CoB’s, and pre-authorizations issued by Risk department).
Client Relations:
- Courtesy calls made to members, corporate groups, and brokers;
- Communication to members with regards to credit reimbursements and zero amounts;
- Escalate complicated, sensitive, and high-profile queries;
- Refer potential clients to the Sales department;
- Provide existing clients with information relating to products and services;
- Maintenance of individual and corporate client (HR managers, brokers, and members) records updated on the database;
- Resolving client complaints: determining the cause of the problem; find the best solution to solve the problem; expediting correction or adjustment; and follow up to ensure resolution;
- Coordinate annual renewals and management of contract expiry dates;
- Refer terminations within the shortest possible turnaround time to the Sales Department for retention purposes;
- Execute with any task as required by following the standard working procedures;
- Provide accurate, valid, and complete information by using the right tools and correct procedures.
Employer group relations in collaboration with the Client Relation Team:
- Employer group presentations, training, and overall visibility;
- Employer group scheduled onsite visits;
- Weekly feedback to line managers, and monthly reporting for the department;
- Share information and new developments as it becomes available;
- Communicate directly with brokers, aid with onsite corporate group induction sessions and ongoing training;
- Relationships building with internal and external stakeholders.
Financial Responsibilities:
- To assist and support the Client Relation Specialists to obtain, view, interpret, and explain:
- Member statements;
- Member & Provider claims received, processed & paid including zero amounts;
- Utilization reports;
- Debt reports;
- Billing schedules;
- Contract details (start and end dates).
Ad hoc assignments:
- Planning, organizing & implementation of Health events for groups;
- Manage monthly corporate group’s visiting/training schedules.
Requirements
- Minimum two-years’ client relations experience;
- Team orientated;
- Any experience in the medical aid or insurance industry is an advantage;
- Client orientation, professional and friendly demeanor;
- Excellent communication and presentation skills;
- Must perform independently;
- Must possess effective organizing and coordinating skills;
- Treat sensitive information confidential;
- Attentive to detail;
- Valid driver’s license;
- Bilingual (English and Portuguese);
- Willing to travel;
- Valid passport.
