Mautoane Mosia

Personal Information Validation (PIV): • Preparing an outbound call on Connex AI by updating the client's cell numbers and assigning the case to myself. • Sending PIV SMS to the client's updated number and PIV email to the Intermediary in question. • Conducting the PIV interview (Asking life insured medical questions) as per the Script or SOP provided and probing when necessary. Finally, close the outbound call according to the situation encountered while conducting it. E.g.. Voicemails or a callback, or the customer is not interested. • Reporting/Escalating a non-disclosure confirmed by the client and unawareness of the cover to the relevant department. And updating the live Excel spreadsheet accordingly. Assess administration: • Assisting in sending out requirements and communication after pre-assessing new claims. • Referring suspicious claims for forensic investigation and continuously keeping the claimant/correspondent updated till the Forensic verdict/outcome has been provided. • Sending out Emails and SMSs to the claimant/correspondent(broker) and thereafter following up on the correspondence sent telephonically on claims still outstanding, requirements for further assessment. • Diarizing after following up and routing the case to the assessors in case there are new requirements received after the last worksheet, capturing the cases in the relevant system thereafter. • Corresponding with the claimant/correspondent telephonically/email regarding any claim decision (Approved, deferred, and voided) taken after receiving all claim requirements. • Issuing payment letters to the correspondent/broker when a claim is paid. • Finalizing any kind of queries regarding the claim at the point of contact. Medcoding: • Verifying if the personal details on the medical examination documents match the client’s details on the Bizagi system. Accepting and deferring accordingly should there be questions unanswered and/or unfilled sections on the medical examination form.

Role Description & Key Result Areas: • Deal with client enquiries via telephone (inbound and outbound), email, and web-chat. • First contact resolution of applicable queries/ transactions. • Deals with first level escalations and complaints. • Effectively manage customer expectations Customer Service Delivery • Initiates processes and deals with clients requests across different platforms while adhering to productivity standards. • Deals with first line queries and escalates complex queries appropriately (inbound and outbound • Finalizes request at point of contact where possible. Relationship building • Converse with our customers in a way they fully understand and provide helpful solutions and products based on their needs and providing an exceptional customer experience. • Always comply with procedures and processes contained in the relevant business guidelines and understand the risk associated with decisions. • Demonstrates behavior in support of the organizational values. • Takes accountability for own performance, personal and career development. • Contribute to the overall effectiveness and success of the team. • Maintain an ability to adapt to ever changing business and customer needs.

Skills: Office Administration · System Administration · Organization Skills · Finance · OMP · Facilitation · Data Entry · Administration · Xplan · Attention to Detail · Work Orders