ROLE PURPOSE

 

To deliver seamless, high-quality customer service across multiple communication channels including voice, email, live chat, social media, and digital platforms, ensuring consistent customer experience and resolution at first contact where possible.

 

Key Responsibilities


Functional Management

  • Respond to customer queries across all channels including WhatsApp, email, live chat, social media, calls and digital platforms.
  • Resolve customer complaints professionally, aiming for first-contact resolution.
  • Accurately capture all customer interactions and update member information on Nexus and other applicable systems.
  • Meet service level agreements (SLAs), quality standards and productivity targets.
  • Provide customers with clear guidance on products, policies and processes.
  • Escalate complex queries in line with SOPs.
  • Identify recurring issues, service gaps and opportunities for improvement.
  • Log potential new member details on the leads platform.
  • Document all interactions according to SOP requirements.
  • Complete daily activity logs and produce required reports.
  • Research required information using available systems and resources.
  • Serve as operational backup for the Contact Centre when required.
  • This role is shift based and includes Saturday work hours.

Risk & Compliance

  • Adhere to fraud controls, governance frameworks and risk-prevention principles.
  • Support internal, external and ISO audits by providing required evidence and documentation.
  • Maintain quality and risk management standards, including ISO9001:2015 requirements.
  • Uphold all relevant SLAs to minimise business risk and support continuity.
  • Assist in reviewing SOPs to optimise service excellence.
  • Comply with all company policies, regulatory requirements and Standard Operating Procedures.

      Stakeholder Engagement

  • Build and maintain strong relationships with internal and external stakeholders.
  • Liaise professionally with members, brokers, healthcare professionals and third-party service providers to ensure excellent customer experience.


EXPERIENCE

QUALIFICATION

  • Minimum 5 Years’ Experience in Customer Service
  • Minimum 5 Years’ Experience working on omni-channel digital platforms
  • Minimum 5 years working experience in a medical Scheme/Medical Administrator
  • Minimum technical knowledge 5 years of NEXUS system experience

 

  • Grade 12 / Matric / NQF Level 4
  • Any qualification higher than that will be advantageous

Knowledge

Skills

Attributes

  • Relevant legislation and regulatory frameworks
  • Technical problem-solving principles
  • Annexures and Scheme Rules
  • Medical Insurance
  • Call Centre Systems and processes
  • Verbal and Written Communication
  • Comprehension
  • Time management and adaptability
  • Decision-Making
  • Analytical Thinking
  • Conflict management
  • Problem-solving and conflict resolution skills
  • Presentation skills
  • Computer literacy
  • Customer service
  • Resilience
  • Detail Orientation
  • Innovative Thinking
  • Customer Centric
  • Results Focused
  • Quality Focused
  • Assertiveness
  • Compliance Driven
  • Innovative thinking
  • Analytical Thinking
  • Problem Solving
  • Emotional intelligence and empathy
  • Strong written and verbal communication abilities

 

 

 
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