Overall Purpose of the Job

Reporting to the Supervisor Contact Centre, the Contact Centre Nurse is responsible for providing high-quality customer service with respect to medical and general customers.

Key Responsibilities

• Handling customers’ queries, complaints, and instructions received through all communication channels e.g. Calls, Emails etc, within a 24-hour coverage. 
• Drive progress towards the goal to reduce operational costs and increase the total number of customers via retention by answering calls in a professional and informative manner.  
• Issuance of both Inpatient (IP) and outpatient (OP) approvals for admissible requests for insured members within the policy guidelines, and as per the approved SLA. 
• Adherence to admission and discharge protocol for claims reserve, authorized cost, cover benefits and duration. 
• Assisting Care Managers in case management, evacuation and emergency response processes. 
• Communication with stakeholders on the management of cases and financial liability through calls and emails. 
• Respond to queries from clients, intermediaries, and service providers by answering telephone calls, interviewing clients, and verifying information as well as liaising with Care Managers and Underwriters on the scope of cover for the various schemes benefits. 
• Escalate Customer queries to the relevant job role where necessary. 
• Maintain a professional ambience at all times, especially while discharging official duties. 
• Maintain and improve quality results by adhering to standards and Customer Experience guidelines.  
• Maintain the communication process by logging in 90% of interactions through CRM (Customer Relationship Management) for visibility. 
• Promote the AAR insurance’s Customer Service Charter. 
• Support all internal and external AAR insurance medical and general business activities and those of stakeholders. 
• Any other duties as may be directed by the management from time to time. 

Education, Experience & Competencies

• Bachelor’s Degree/Diploma in Nursing (KRCHN), Health Management or in a related field. 
• Possession of Health System Management qualifications would be an added advantage.
• Kenya Registered Nurse/Kenya Registered Community Health Nurse. 
• 2-3 years’ relevant experience in Care Management with a medical underwriter. 
• Experience in a medical/insurance Call Centre unit will be an added advantage. 
• Good analytical, reporting, presentation and problem-solving skills. 
• Ability to handle sensitive and confidential information discreetly. 
• Emotional intelligence. 
• Strong organizational skills; ability to prioritize work and meet deadlines. 
• Computer literacy (MS Word, PowerPoint and Excel expert). 
• Planning and organizational skills. 
• Understanding of the working environment. 
• Regulatory compliance (Basic knowledge of regulations by AKI and IRA).