About KaeloKaelo provides essential healthcare solutions ensuring the physical and psychosocial wellbeing of all South Africans towards lasting social change. Kaelo meets the Healthcare needs of Corporate and Retail clients across South Africa – products offerings include Medical Insurance, Medical Aid, Gap Insurance, Kaelo Money and employee assistance programmes.Job DescriptionThe Executive Office Consultant manages all stakeholder escalations and complaints with the highest level of excellence, exercising a large degree of individual discretion. Working independently but collaborative in nature and ensuring continuous improvement and process improvement.Key OutcomesManage service and channels: Direct, Indirect and outbound. Health Escalations within a 2 hour turnaround time.Manage all stakeholders with a focus on Health Escalations.Manage operational queries with immediate action and expectations.Manage escalations and complaints:Ensure the complaints and rejection data is analysed to identify and address recurring or systematic problems and potential operational risks by:Analysing the causes of individual complaints to identify root causes common to different types of complaints.Considering whether such root causes may also affect processes or products, including those not directly complained of.Correcting, where reasonable to do so, such root causes.Conduct monthly trend analysis.Ensure that proper feedback and trends analysis are documented and communicated to the relevant departments.Reporting and maintenance of all relevant registers.Manage Oncology Cuddle call program.High touch claims report management.Focus on the customer journey and any improvements thereof.QualificationsSPECIAL REQUIREMENTSPERSON DETAILS: WORK EXPERIENCEREQUIREDExecutive queries and complaints resolution.Knowledge and experience in the Health Industry.PREFERREDMatric.Knowledge of FAIS legislation.3 Years' experience within the Gap Cover industry.TECHNICAL SKILLS OR KNOWLEDGEREQUIREDTime management.Excellent verbal and written communication skills.
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