Job ID: 23275
Location: Head Office, Bellville
Full/Part Time: Full-Time
MMI Holdings Limited (MMI) is a South African based financial services group listed on the South African stock exchange, the JSE. The group operates in the market through multiple client-facing brands including insurance and investment brands Metropolitan and Momentum, South Africa’s number one cell captive insurer Guardrisk and wellness & rewards programme Multiply. MMI operates in 14 countries, 12 in the African continent, United Kingdom and India through a direct presence, strategic partnerships and joint ventures.
MMI’s purpose is to enhance the lifetime Financial Wellness of people, their communities and their businesses. Financial Wellness is a continuous process of planning and management for individuals, households and businesses, with the aim of affording expenses and achieving goals over one’s lifetime. Our promise to our clients is to be their Financial Wellness partner over this life-long journey, using our expertise and solutions to help them develop and reach their goals. Visit us at www.mmiholdings.co.za
Metropolitan is one of the oldest financial services brands in South Africa. With a 116 year legacy of serving the communities in which it operates, Metropolitan represents true empowerment in serving Africa’s people through affordable financial solutions that create financial growth and security.
Metropolitan operates in South Africa, but the brand is also present in 12 African countries including, Namibia, Botswana, Kenya, Ghana, Nigeria, Lesotho, and Swaziland.
Metropolitan provides financial wellness solutions that meet the needs of low income clients, including funeral insurance, health, savings, hospital cash-back cover, retirement solutions and life insurance.
WHAT YOU’RE GOING TO DO
- This role offers exciting and challenging opportunities and is aimed at a dynamic, performance orientated, Knowledgeable and experienced individual, who is able to deliver quality outputs in a highly deadline and client orientated environment.
- You will be required to work well within a team aswell as on your own. An exciting opportunity exists for an experienced staff member to take up a challenging position as a Quality Assessor in our Bellville office
RESPONSIBILITIES AND WORK OUTPUTS
- Telephonic Surveys and Assessments of claims enquiries
- Claims Assessments / re-processing experience
- Identifying and reporting of problem areas, trends and training needs with the focus on development of Claims Assessors / Specialists
- Communicating regularly with the Quality Assurance Manager, Customer Services
- Managers, Claims Managers and Customer Services Team Leaders in terms of assessment scores and findings
- Liaising with all the relevant role players in the event of disputes regarding customer satisfaction measures in order to ensure accurate and consistent application of procedures
- Facilitating training sessions as and when required
- Coaching of Quality Assessors / Specialists and Team Leaders to achieve desired quality levels
- Ability to remain impartial
- A high focus on customer satisfaction
- Ability to maintain co-operative working relationships
- Ability to work under pressure and work independently
- Ability to coach and give constructive feedback
- Analytical and problem solving skills with the ability to make decisions
- Ability to communicate recommendations in a constructive manner
- Excellent interpersonal skills and communication skills (both written and verbal)
- Ability to liaise with clients extensively via the telephone while maintaining high energy levels of assertiveness
- Sound knowledge of Board of Health Funders (BHF) tariff guide
- Sound knowledge of scheme rules and benefits
- Be able to interpret payment instructions from relevant SPN’s
- Be able to read claims raw data and access real-time claims
- Be able to audit different kinds of claims
EXPERIENCE AND QUALIFICATIONS
- Matric or Grade 12 qualification
- 1-2 years claims assessing experience preferably in a Medical Aid industry
- 1-2 years claims experience
- Supervisory experience or quality management experience would be an advantage
- MS Office proficiency and Call Centre applications (inclusive of the assessment system)
- Business Writing Skills would be an advantage
- Shortlisted candidates will be subject to the following statutory checks:
- This advert is not open to agencies
- Note that we reserve a right not to fill this vacancy. Should you not be contacted
- within two weeks, please consider your application unsuccessful
Only on-line applications submitted via our careers page will be considered.
Internal Team Members must inform their manager of their application. Your manager must be aware of and support your application
All positions will be filled in accordance with our Employment Equity plan.
We also encourage people with disabilities to apply.