Service Recovery Consultant MMH250605-6

Role Purpose

Deliver professional service to clients through various servicing channels (inbound calls, emails, walkin interactions etc.), responding to their needs, concerns and complaints within agreed Service Level Agreements and legislative and compliance requirements, To engage with clients in an efficient manner in order to respond and resolve their queries effectively and according to service level agreements.

Requirements

• 5-6 Years experience in a call centre or client service environment with proven knowledge of customer service principles and practices Exposure to the insurance industry (preferred).
• Proven experience working with GEMS Medical Aid is essential.
• Hands-on experience using Reflections (claims and administration system) is a mandatory requirement.
  
  

Duties and Responsibilities

PROCESS / OPERATIONS

• Engage with clients and intermediaries in a professional, client-centric manner to resolve queries within agreed service-level agreements (SLAs) and quality standards.
• Own and resolve complaints timeously; track queries to closure and use insights to improve business processes.
• Provide clients with all required information and documentation in line with policy guidelines and compliance requirements.
• Capture, update and maintain client data accurately on the relevant systems.
• Process payment corrections and perform account reconciliations to ensure accurate disbursements.
• Complete all administrative and reporting tasks accurately within agreed time-frames.
• Identify and report process or system failures, as well as potential enhancements, to improve the overall client experience.
• Adhere to all legislative, governance and compliance requirements throughout the service process.
  
  

CLIENT / SERVICE

• Investigate and resolve client queries within SLA; escalate to relevant departments or stakeholders when necessary.
• Provide authoritative advice and after-sales support to clients and stakeholders.
• Build and maintain strong relationships with clients, internal teams and external partners; deliver on all SLA commitments.
• Monitor turnaround times and quality standards continuously, taking corrective action where required.
• Provide regular reports on service delivery against agreed targets, and recommend initiatives that enhance client service and ensure fair treatment.
• Contribute to and sustain a culture that encourages feedback, rewards relationships and delivers exceptional client service.
  
  

PEOPLE

• Develop and maintain productive, collaborative working relationships with peers and stakeholders.
• Positively influence and participate in change initiatives; offer specialist support where required.
• Continuously grow professional, industry and legislative expertise; share knowledge and innovative ideas with the team.
• Participate in a culture of productivity, quality management and service excellence.
• Take ownership of personal career development and help cultivate a learning mindset across the team.
  
  

FINANCE / GOVERNANCE

• Contribute to area-specific financial planning and identify opportunities to enhance cost-effectiveness and operational efficiency.
• Manage financial and other company resources under your control responsibly.
• Implement and provide input into governance processes, systems and legislation within the area of specialisation; escalate unresolved compliance issues through the proper channels.
• Provide input into risk-identification processes and communicate recommendations in the appropriate forums.
  
  

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