Tamheer - Healthcare

Role Purpose:

Handle all cases received from the outbound related channels and provide world-class service in every interaction for Health Care Center performance and customer satisfaction as per company and department’s standards and provide a competent, courteous, efficient and proactive point of contact for customers both internal and external with high level of quality.

Key Accountabilities:

1- Inbound calls handling;

• Provide a high level of customer service and professional communication skills
• Maintain a thorough knowledge of all departments under Bupa Connect Care products and services so that customers are provided accurate information on networks, treatments, paperwork requirements, and general queries with confidence at all times
• Resolves and inputs provider/client requests into CRM according to established guidelines.
• Ensures proper, accurate records, files, databases are set up and maintained.
• Highlight any recurring problems that are identified and then direct the information accordingly so that corrective actions can be taken promptly
• Ability to use and interpret multiple systems for preauthorization, claims research, contract interpretation, and provider network status
• Capacity to understand and interpret client and provider contracts while working with callers
• Provides customer satisfaction to both internal and external customers and strives to continuously improve service delivery.

2- Excellence Recovery;

• Ensure excellent members recovery from the first interaction
• Ensure proper, accurate records, files, and databases are set up and maintained.
• Ensure fully explain with maintain a high level of NPS survey
• Build a strong relationship with all relative stakeholders to ensure proper resolution

3- Complaints & case management;

• Assure that all the inbound complaints are handled end to end as per the department policy and procedure
• Initiate proper escalation to the relative stakeholders
• Ensure proper recovery for complaints and high level of satisfaction
• Highlight any recurring problems and accordingly take corrective actions to resolve the case.

• Ability to use computers and navigate through software applications.
• Ability to multi-task in a fast-paced changing environment and work well under stress
• Strong trouble shooting, problem-solving and analytical skills
• Excellent follow up skills
• Ability to resolve issues effectively
• Strong background in customer service in insurance or hospitals
• Strong communications skills
• Excellent follow up skills
• Experience in Customer Service, Sales or Call Centre
• Medical & Insurance field knowledge is a major advantage