Health Core Servicing Consultant

  • 52 Corlett Dr, Birdhaven, Johannesburg, 2196, South Africa
  • Full-time

Company Description

About Kaelo
Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change.
 

Job Description

The Kaelo Health Specialised Servicing Consultant is responsible for responding to complex queries, managing complaints, troubleshooting service problems and providing general information regarding our products. Manage our customer and provider experience with excellence and accuracy. As a Specialised Consultant you will be expected to perform using a variety of channels, including telephonic and correspondence as well be skilled on all Kaelo products. Management of the provider relationship from contracting , service level agreements, administration, and reporting.

KEY OUTCOMES
Manage networks
Rango appointment management and reporting on the Halo network
Management of authorisations

Grow and maintain network providers
Maintain contact information and communicate and store according to the business rules and requirements
Maintain on-boarding and off-boarding of health providers
Maintain client information  

Resolve network related escalations
Ensure maintenance of SLA’s and correct escalation protocols are adhered too

Source and contact health providers
Report on networks and appointments
Weekly and monthly reporting , but not limited to this frequency
Negotiate annual tariffs

Manage incoming queries and outbound responses with:
Members
Service Providers
Intermediaries
Health Providers
RAF (Road accident fund)requests manage relationship with third party stakeholder

Manage omni-channel responses (including telephonic and correspondence) 
Provide product specific information across full product suite

Assess and determine when there is an operational query and or complaint
Identify and escalate priority issues

Manage and resolve customer and health provider complaints
Complete administrative tasks 
Continuous improvement and quality assurance
Monitor and manage trends
Conduct root cause analyses

SPECIAL REQUIREMENTS
Ability to maintain confidentiality, problem solve, negotiate and communicate, attention to detail. Ability to handle stressful situations appropriately 
 


 

Qualifications

PERSON DETAILS: WORK EXPERIENCE
REQUIRED
At least 3 years’ experience in the Medical Scheme or Healthcare Industry in a data administration role 
Knowledge of customer service practices and principles
Excellent listening, verbal and written communication skills 
PREFERRED
Proven work experience in the Healthcare administration or managed care environment

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY
REQUIRED
Grade 12 or equivalent NQF 4 certificate
PREFERRED

TECHNICAL SKILLS OR KNOWLEDGE
REQUIRED
Computer Literacy – Microsoft Excel, Word and PowerPoint
Strong phone, email (written) and inter-person communication skills
Call centre systems and multi-tasking
PREFERRED
Knowledge of Medical Scheme Industry
 

 

Additional Information

 

  •       Accountability
  •       Action orientated
  •       Collaborative
  •       Communication skills
  •       Simple writing skills
  •       Problem solving skills
  •       Encourages engagement
  •       Manages complexity
  •       Resilient and adaptive
  •       Purpose driven
  •       Significance and values orientated