About Kaelo
Kaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa – products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.

The Executive Office Consultant manages all stakeholder escalations and complaints with the highest level of excellence, exercising a large degree of individual discretion. Working independently but collaborative in nature and ensuring continuous improvement and process improvement

KEY OUTCOMES (not limited to) Level 4 and 5 process elements

Manage service and channels: Direct, Indirect and outbound. Health Escalations within a 2 hour turnaround time.

Manage all stakeholders with a focus on Health Escalations.

Manage operational queries with immediate action and expectations

Manage escalations and complaints

- Ensure the complaints and rejection data is analysed in order to identify and address any recurring or systematic problems and potential and operational risks by:

-- Analysing the causes of individual complaints so as to identify root causes common to the different types of complaints

-- Considering whether such root causes may also affect the processes or products, including those not directly complained of; and

-- Correcting, where reasonable to do so, such root causes

- Conduct monthly Trend analysis

- Ensure that proper feedback and trends analysis are documented and communicate to the relevant departments

- Reporting and maintenance of all relevant registers

- Manage Oncology Cuddle call program

- High touch claims report management

- Focus on the Customer journey and any improvements thereof

SPECIAL REQUIREMENTS

PERSON DETAILS: WORK EXPERIENCE

REQUIRED

Executive queries and complaints resolution

Knowledge and experience in the Health Industry

PREFERRED

EDUCATION: QUALIFICATIONS: ACCREDITATIONS WITH PROFESSIONAL BODY

REQUIRED

Matric

Computer literate

Knowledge of FAIS legislation  

Regulatory Exams a qualified representative level

PREFERRED

3 Years’ experience within the Gap Cover industry

TECHNICAL SKILLS OR KNOWLEDGE

REQUIRED

Customer focus

Time management

Excellent verbal and written communication skills

Interpersonal skills

PREFERRED

Product Knowledge

•       Accountability
•       Action orientated
•       Collaborative
•       Communication
•       Business writing skills
•       Manage complexity
•       Problem solving skills
•       Decision thinking
•       Encourages engagement
•       Resilient and adaptive
•       Resourceful
•       Demonstrates self-awareness
•       Purpose driven
•       Significance and values orientated