Medical Call Center Officer

Job Purpose

Officer in the customer service call centre role is to provide exceptional customer service support to customers and/or insured members. Will handle high volume of incoming calls, chats and emails inquiries, and complaints, ensuring prompt and effective resolution while maintaining a high level of customer satisfaction. Assist in department activities and tasks as and when requested. Call Centre is a 24/7 operation, so rotational shifts will apply, including night shift.

You will also be required to support with pre-approvals, claims adjudication and customer service. Key Performance Indicators: Our KPIs provides insights into the efficiency, effectiveness, and overall customer satisfaction of the customer service officer/representatives in their role, but not limited to the below and will be as per business and department strategy and direction.

• Customer Satisfaction (CSAT) score
• First contact resolution (FCR) rate
• Average handling time (AHT)
• Abandoned rate
• Quality Assurance (QA) Score
• Escalation rate
• Knowledge (usage system and tools to resolve customers and/or members inquiries and issues)
• Occupancy
• Status: Log-in time, talk time, Hold time, After work time)
• Call/Chat Transfer rate Key Accountabilities Customer Interaction:
• Handle incoming/inbound customer and/or members inquiries, requests, and complaints through phone, chat and email channels, in a timely and professional manner
• Carry out outbound calls to customers/Insured members on a follow up, clarifications, courtesy calls and or satisfaction calls and other proactive outbound calls flagged as an outbound campaign
• Show strong communication skills, active listening and showing empathy to customer enquiries, concerns, and complaints, and provide accurate and appropriate information and/or resolution
• Follow established procedures and guidelines for issue resolution
• Ensure accurate information wrap up/after call work log after each interaction. Product Knowledge:
• Develop and maintain a comprehensive understanding of the organisation's products or services, including features, table of benefits, terms and conditions...etc
• Stay up to date with customer servicing updates, company applications to provide accurate and relevant information to customers and/or insured members. Team Collaboration:
• Assist with tasks and activities as and when request by department leads and /or management
  
  

Contribute to a positive and collaborative team environment, fostering culture and continuous improvement. Customer Satisfaction and Quality Assurance:

• Deliver exceptional customer service and a positive customer experience whilst meeting all SLA's/KPI's Process Improvement:
• Follow the company and department policies & procedures and ensure code of conduct is always applied. Adaptability and Resilience:
• Adapt to changing circumstances, customer demands, and business requirements, while maintaining composure and professionalism in challenging situations
• Demonstrates resilience in handling difficult customers or high-pressure situations. Communication & Working Relationships Internal
• Coordinate with department team members and other operation departments. External
• Respond and interact with customers and/or insured members in a timely and professional manner
  
  

Requirements

Qualifications, Experience & Skills Minimum Qualifications:

• Bachelor's degree in business administration and/or any equivalent; additional certifications or education in customer service is a plus
• Medical Qualification/background. Minimum Experience:
• 6months - 2years proven experience in a customer service role, preferably in a contact center or call center environment
• Experience in the insurance and healthcare industry is a plus. Job-Specific Skills:
• Excellent English verbal and written communication and interpersonal skills
• Strong problem-solving and critical thinking skills and abilities
• Ability to handle high volume of calls and work under pressure in a fast-paced environment
• Proficiency in using customer service software, systems, and any other relevant tools
• Computer Literacy is required
• Ability to work flexible hours /shift base, including evening, overnight, weekend and holidays as per the business requirements. Required Competencies
• Customer focus
• Teamwork and collaboration, Self -motivated, Dependable, and Open-minded
• Problem-solving
• Empathy and Patience
• Service and Product Knowledge
• Cross-cultural competence
• Adaptability and Flexibility
• Continuous learning
• Time management and Multitasking
• Adapting and Resilience Version No. 2 Job Description Form - Guidelines No of Pages 3