Diploma or Bachelor's degree in Nursing, Clinical Medicine, Public Health, or Healthcare Management or equivalent.
Added Advantage
Professional qualification in AIIK, ACII, or Certificate in Insurance.
Formal training in customer experience or call centre operations.
Knowledge of medical scheme operations, SLAs, and healthcare provider management.
Understanding of ISO Quality Standards and Data Protection Act compliance.
Experience
Minimum of 2 years' relevant experience in medical insurance administration, provider relations, or healthcare scheme management, preferably within an insurance company, brokerage firm, or medical service provider network.
Experience in a customer-facing, call centre, telehealth, or health insurance environment is an added advantage.
Core Competencies
Strong background in medical insurance servicing, including healthcare claims, member and provider management.
Excellent communication, interpersonal, and client relationship skills.
High integrity, professionalism, and strict commitment to patient and member confidentiality.
Ability to translate complex clinical or benefit information into clear, plain-language communication for members and providers.
Excellent verbal communication, active listening, and empathy skills — particularly in handling distressed, unwell, or frustrated callers.
Strong understanding of health insurance concepts including claims, pre-authorizations, benefit limits and exclusions.
Sound judgement in recognizing when a caller's situation requires escalation to a Care Manager, clinician, or emergency services.
Ability to work under pressure, manage multiple queries simultaneously, and maintain accuracy and composure in a fast-paced call centre environment.
Results-oriented, punctual, and committed to meeting service-level agreements (SLAs) and quality assurance standards.
Application deadline2 Nov 2026
GK
This is a preview of the role
Sign in to your GoKazini account to see the company name, full job details, salary information, and how to apply.