CLIENT RELATIONS OFFICER – Associated Fund Administrators (AFA) Botswana (Pty) Ltd

Associated Fund Administrators (AFA) Botswana (Pty) Ltd, a company involved in the administration of Botswana Public Officers Aid Scheme (BPOMAS) and Pula Medical Aid Scheme, invites applications from suitably qualified persons for the following position in the Front Office Department, a 1x Client Relations Officer (pensionable) at the Francistown Branch

1 x CLIENT RELATIONS OFFICER – FRANCISTOWN (PENSIONABLE POSITION)

Main purpose of the job

Reporting directly to the Client Support Coordinator and the Branch Manager, the incumbent will be required to: receive, maintain a record of, track aging and resolve queries from Service Providers, Scheme members and stakeholders. Accurately and timely address enquiries and queries from members, service providers and stakeholders. Issue confirmations and authorisations for medical procedures in accordance with scheme rules and benefit limits.

Key Performance Areas

• Receives, manages, resolves queries and provide feedback to medical aid scheme members and service providers within set turnaround times.
• Compile and prepare information and send to the Medical Advisor and/or Underwriter for advice and may refer to the Management Committee for further decision making
• Confirms availability of benefits for outpatient medical procedures.
• Counsel clients who have exceeded benefits and excluded conditions
• Prepares requests for expedited claims processing and payments
• Prepares and submits motivations for escalated medical requests and services for Management consideration and approval
• Stakeholder Management
• Educates members and service providers on Scheme rules benefits and relevant tariffs.

 

 

 

Key Competencies

• Clinical Knowledge
• Teamwork
• Adaptability
• Assertiveness
• Conflict management
• Problem solving skills
• Interpersonal sensitivity
• Communication and business writing skills
• Attention to Detail and accuracy
• Knowledge and application of relevant legislation
• Strategic awareness
• Demonstrate Customer service orientation
• Results driven
• Knowledge and application of processes, procedures and scheme rules
• Computer Technology Skills and Relevant systems knowledge and application

 

Qualifications, Experience and Competencies

• The candidate should have 4 years or more relevant clinical, medical aid industry, customer service experience.
• The company offers a competitive remuneration package commensurate with an organisation of its size.