Job Overview:

The primary responsibility of a Care Advisor is to handle telephone inquiries related to the company’s products and services, adhering to established scripts and procedures. The role requires ensuring that all calls are answered within defined service levels while maintaining the highest standards of customer service excellence. In addition, the Care Advisor is responsible for accurately documenting details of each interaction, including actions taken, to facilitate follow-ups and any necessary corrective measures. The role also involves maintaining effective communication with the Care Centre Team Leader and Assistant Manager, while consistently delivering a customer-focused service experience.

Key Responsibilities:

• Promotes a customer-centric culture within the Care Centre by delivering effective solutions to customer concerns and inquiries.
• Adheres to communication and update standards in line with Nextcare policies, scheme requirements, and agreed turnaround times.
• Handles inbound calls and assists customers and providers with specific requests and inquiries.
• Conducts outbound calls for case follow-ups, collection of medical reports, second opinions, and complaint management.
• Enhances customer awareness and engagement with the company’s products and services.
• Delivers high-quality, personalized customer service at all times.
• Maintains and updates customer/member records and ensures data accuracy in the system.
• Records details of interactions and actions taken to support continuity and follow-up.
• Maintains effective communication with the Care Centre Team Leader and Assistant Manager.
• Ensures proper documentation, call closure, and coordination with relevant departments.
• Evaluates issues thoroughly and provides logical solutions within the defined scope of authority.
• Reviews and processes pre-approval cases exceeding standard turnaround times to ensure timely resolution.
• Issues Guarantee of Payment (GOP) documents as required to support seamless patient care.
• Work effectively with AI, machine learning, data analytics, and cloud-based tools while adhering to high standards of data governance, security, and ethical use

Key Requirements:

• Bachelors Degree ; Medical background preferred.
• 0 -2 years experience in a Call Centre/ Customer Service environment, TPA Hospitals or Medical Centers exposure a plus.
• Strong communication skills in English (additional languages are an advantage)
• Good understanding of customer service principles and telephone etiquette
• Physically fit to carry out duties.
• Legally permitted to work in the country of operations.
• Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.