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