Medical Contact Centre Assistant

Britam Holdings Plc is a diversified financial services group based in Kenya, offering a range of insurance and financial products. Founded in 1965, it operates in the banking, finance, and insurance sectors.

The Medical Contact Centre Assistant is responsible for managing client interactions via calls and emails, ensuring professional and informative communication. This includes logging all interactions in the CRM system, providing prompt and accurate responses to clients, and appropriately assigning tickets to relevant personnel or departments to ensure efficient service delivery.

1. Manage customer inquiries, complaints, and instructions received through various communication channels like calls and emails.
2. Engage with clients, intermediaries, and service providers to ensure healthcare services are delivered according to policy guidelines.
3. Establish appropriate parameters for admission cases, including claim reserves, initial authorized costs, and cover benefits.
4. Respond to queries from clients, intermediaries, and service providers by answering calls, interviewing clients, and verifying information.
5. Coordinate with underwriters regarding the scope of cover for different medical schemes.
6. Ensure continuous availability of support for medical scheme members.
7. Prepare regular care reports for management on medical issues.
8. Maintain and improve service quality by adhering to established standards and guidelines, suggesting procedural improvements to achieve QA score targets.
9. Ensure outpatient approvals for clients are issued via email within the agreed Service Level Agreement (SLA).
10. Facilitate appropriate admissions and discharges for patients.
11. Document all client interactions in the CRM system for traceability and visibility.
12. Monitor and manage the telephone budget allocation to ensure proper line diversion.
13. Adhere to the approved Delegated Authority Matrix.

1. Hold a Degree or Diploma in Nursing or a related medical field.
2. Possess 3 to 5 years of experience in a similar role.
3. Have knowledge of insurance regulatory requirements.
4. Be familiar with Britam's products and services.