Purpose of the Job Responsible for resolution of queries in accordance with the medical scheme rules and legislation. Professional customer services work at an advanced level involving answering phone calls and resolving queries, complaints and providing information and educating the members. Resonsibilities Telephonic liaison and written response to members and suppliers Search files and records for information related to complaints/queries and determine solutions to the problems according to the company's policy and procedures (telephonically or in written format) Liaison with members, providers, internal departments and Healthcare partners Complete all related administration work. Provide feedback to members, Healthcare suppliers on the enquiry/complaint Work out quotes on dental-, optometry etc. benefits and quote the member/provider correctly. Utilise and record information using the elected systems Checking accounts for amendments and resubmissions. Desired Skills: 3 to 5 years Experience in the Healthcare industry Desired Qualification Level: Grade 12 / Matric About The Employer: Medical
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