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Call Centre Nurse Aide
Job Description
- The Information Centre Care Agent is responsible for managing all incoming calls to the OLD MUTUAL Medical emergency hotlines.
KEY TASKS AND RESPONSIBILITIES
- Answer incoming telephone calls into the Call Center in a professional manner at all times
- Working with providers and the OLD MUTUAL Case management team to manage the admission and discharge process of OLD MUTUAL Members
- Managing requests for services from providers, intermediaries and clients, providing information on the OLD MUTUAL provider network, available benefits per scheme policy and services and other routine information
- Processing pre-authorization requests for outpatient services
- Provides health information to customers via OLD MUTUAL approved resources
- Completes accurate and timely documentation of all services provided to callers
- Escalate / liaise with claims/ care teams on any issues which require further consultation
- In conjunction with Smart applications resolve card issues raised at the point of service.
- Attends all required training sessions and meetings.
- Normal information center duties. E.g. carrying out customer surveys, social media and email management.
- Performs all other tasks as assigned by the Information Center Manager, Case Management Supervisor, Medical Case Management Manager and/or Medical Claims Manager.
SKILLS AND COMPETENCIES
Competences
- Basic level of proficiency with Windows based applications such as MS Office, Excel, Word
- Proficient ability to analyze data and develop recommendations
- Strong verbal and written communication skills
- Maintains a professional/customer service focus at all times.
Qualifications & Requirements
- Availability to work any both day and night shifts
- 1+ years in Patient Customer Service Experience Preferred
- 1+ years Call Center experience Preferred
- 6+ months professional experience in an office setting using the telephone and computer as primary instruments to perform the job duties
- Knowledge of medical terminology/Coding (ICD10)
- Bachelor’s Degree or Diploma in Nursing
- Experience working in the Insurance industry preferred
- ACII or Other Insurance Certification Preferred
Actuarial Graduate Trainee
Job Description
- To carry out valuation of technical liabilities in GI and Health business, capital adequacy assessments, prepare board reports, actuarial analytics, induct and supervise interns and carry out any other duties as delegated by the Head of the GI & Health actuarial department.
KEY TASKS AND RESPONSIBILITIES
- Assist in the valuation of Technical Liabilities in GI as delegated every mid-month and end month.
- Board Reporting – Carrying out analysis and compiling board material for Old Mutual GI entities.
- Computation of Kenya loyalty awards – Involved in the setting of parameters and computation of the monthly, quarterly and annual awards.
- Profitability, Product and Pricing Reviews for both GI and Health – As and when requested by the business Aid the senior actuarial analyst in capital adequacy assessments
- Review of claim reviews and other duties done by the actuarial intern – Follow up on meetings and issues raised.
- Ad-hoc Duties – As and when requested by the business.
- Follow up on the department’s requisitions on D365.
QUALIFICATIONS
- Graduate with a BSc Actuarial Science degree
- Progress in Actuarial Professional Papers (IFoA).