Introduction    

• Support with overflow quality assurance in the claims area by quality assessing all customer interactions and operational processes within the Admed team.

Role Purpose    

• Support with overflow quality assurance in the claims area by quality assessing all customer interactions and operational processes within the Admed team.

Requirements    

• Preferred (but not essential) post-matric qualification (certificate, diploma or degree) in commerce (quality assurance, administration, insurance, etc), or studying towards a tertiary qualification 
• Efficient in MS Office computer skills (MS Office suite)
• At least 2 years’ working experience in quality assurance and 1 year’s working experience in medical, health insurance and/or gap cover claims processing
• Thorough knowledge and understanding of the performance standards, rules and regulations
• Experience in an insurance environment an advantage 

Duties & Responsibilities    

• Participating in the design of quality standards and monitoring formats across all areas of the Admed business, including the front office client (incoming and outbound calls; incoming and outbound emails), premium administration area and claims processing area;
• Performing monitoring as well as system audits across all of these areas;
• Preparing for and participating in call calibration sessions for all staff;
• Completing call simulations for all new staff;
• Attending to all internal QA related queries;
• Creating and maintaining relevant QA tracking sheets;
• Preparing weekly, monthly, quarterly and annual reports and trend data to communicate outcomes of quality activities and maximise operational performance and efficiencies;
• Providing feedback to line managers for coaching sessions on quality issues identified as well as identifying training needs and reporting on training interventions required for business to meet its quality standards;
• Working with business and technology concerns to maximise operational improvement;.
• Providing quality assurance support to the claims quality assurance team on overflow claims;
• Ensure that the principles of TCF are delivered across every function performed, with a specific focus on the achievement of:
• TCF Outcome 4 – Customers are provided with clear information and kept appropriately informed before, during and after point of sale; and
• TCF Outcome 6 -Customers do not face unreasonable post-sale barriers to change product, switch provider, submit a claim or make a complaint.

Competencies    

• An excellent command of the English written and spoken language as well as a good command of the Afrikaans written and spoken language
• Strong customer service orientation
• Passionate about developing people and achieving levels of excellence
• Organised and focused
• Self-driven with an ability to work independently as well as to function effectively within a team
• Results and solutions driven with a strong sense of responsibility and ownership
• Analytical skills
• Attention to detail and accurate
• Resilience and ability to work under pressure
• Ability to communicate effectively with all levels of staff
• Computer literate
• Adaptability, initiative and willing to go the extra mile where necessary
• Discipline, reliable and good time management skills
• The ability to remain interested and focused when repeating processes

Closing Date: 20th, July 2022