The Contact Centre Clinical Executive is responsible for delivering efficient, accurate, and professional customer support through multiple communication channels, including phone calls, email, and other available platforms.
Key Tasks and Responsibilities
Enquiry Management: Answer all incoming calls professionally, providing support for a wide range of enquiries.
Email Correspondence: Respond to all email enquiries and approval requests within agreed turnaround times.
Emergency Services: Manage evacuation and ambulance requests efficiently and promptly.
Case Management: Collaborate with providers and the Case Management team to manage admissions and discharges of Old Mutual members.
Pre-authorization: Process pre-authorization requests for outpatient, dental, and optical services, ensuring quality and cost-efficiency.
Risk Mitigation: Ensure proper adjudication of pre-authorizations and claims in line with Old Mutual policies (e.g., enforcing waiting periods).
Value Optimization: Collaborate with providers and clients to identify cost-effective options and implement initiatives that maximize value for members.
Information Support: Offer detailed and accurate information about Old Mutual’s provider network, policy terms, and available services.
Technical Support: Resolve smart access issues raised at the point of service in conjunction with Smart applications.
Documentation: Maintain accurate and timely documentation of all interactions and services provided.
Escalation: Liaise with claims or care teams on issues requiring further consultation.
General Duties: Participate in training, departmental meetings, and perform contact centre duties including customer surveys and social media management.
Skills and Competencies
Communication: Clear, concise, and courteous verbal and written communication.
Problem Solving: Ability to assess issues quickly and take appropriate action.
Attention to Detail: Accuracy in processing requests and documenting interactions.
Teamwork: Working effectively with internal teams (BPU, Relationship managers, claims) and external providers.
Customer Service Excellence: Professionalism, empathy, and efficiency in client interactions.
Technical Proficiency: Handling contact centre systems (telephony, CRM, email tools).
Knowledge and Experience
Strong understanding of clinical guidelines, healthcare processes, and insurance policy application.
Experience in customer experience delivery.
Qualifications
Bachelor’s Degree or Diploma in Clinical Medicine, Nursing, or a related healthcare field.
Diploma or certification in Insurance Proficiency is an added advantage.
How to Apply
Qualified candidates should apply through the Old Mutual Workday recruitment portal by visiting Old Mutual Kenya Careers. You can also access the application through the MyJobMag portal: Apply Here.
How to Apply
Interested and qualified candidates should apply online via the Old Mutual recruitment portal on Workday. Visit this link which redirects to the official workday job site at oldmutual.wd3.myworkdayjobs.com.
