Complimentary Product Team Leader-MMI Holdings

MMI Health, an entity of MMI Holdings Limited (MMI), delivers sustainable, integrated health solutions that meet the needs of clients in the different segments and maximise lifetime client value. We build and maintain a culture of innovation, and create value through unique insights of how to achieve specific outcomes by using a defined set of Health capabilities.

ROLE PURPOSE

Provide an effective and efficient service to clients by receiving, evaluating and responding to telephonic/electronic enquiries timeously on the Momentum Health and MMI product offering.

WHAT YOU'RE GOING TO DO

Health Returns
Loading of Health Assessment results
Loading of lipogram results
Assisting with HealthReturns/ HealthSaver escalations received from scheme office.
Assisting with HealthSaver/ HealthReturns escalations received from call centre, brokers and across the business.
Providing first time resolution to the contact centre

Answering queries that are sent to bin 9014/9055
Investigation disputes with Multiply if the data does not coincide between us
Investigation/troubleshooting technical issues that has results in non-payment of HealthReturns for affected members.
Raising issues when we come across them
Receive enquiries from contact centre, Multiply directly and colleagues across MMI
Building client relationships with brokers/members and multiply employees to assist with HealthReturns enquiries.
We do corrective adjustments on the ACIE screen if details have updated with Multiply (HHS,Active dayz and Tier status) however is too far back to be included in the Multiply activity file.
Overrides done as an exception if member has not taken chronic and wellness noncompliance based on information provided.
Assist with helping understand calculation of the HealthReturns based on the specific members’ premium, HHS, activity and Tier status
Provide training of the MCARE/ACIE system
Assist with creating training manuals to understand the MCARE/ACIE screen
Assist with queries received to update relationship status that is affecting the Multiply points allocation.
Isolating areas for improvement such as processes, system and client interactions eg Oracle updates.
Momentum Gap Cover
Facilitating seamless claims process implemented from 2018. We either receive a Momentum Gap Cover claim form from the member/Broker submitted via email to the Momentum gap claims email address and on a weekly basis we receive a spreadsheet from MGC directly indicating shortfalls/co-payments and we need to individually submit these claims with the supporting documents (Hospital account, detailed claim statement, relevant Dr’s account and treating specialist account).
We receive a daily report from MGC in order for us to assist with confirming MGC applications received, Progress of application and Cover start date.
Submit requests to MGC directly received via the call centre to update policy details (i.e. banking details, address details, name change , termination requests etc.
Formed a relationship between Juan da Silva and Tshepo Leepile in order to assist answering queries that a member/broke might have that is not stipulated on a policy wording, focus page or confirmation of MGC cover.
Receive a daily report from the membership department that we have to cross reference with the MGC daily report in order to inform MGC of any Momentum Health contracts that have been terminated, as a member can only have MGC with a Momentum Health membership.
We have access to a web portal in order for us to assist the contact centre with Billing enquires (i.e if a debit order is submitted and confirm if it was successful, confirming approved/declined claims submitted to MGC).
Assisting with declined MGC claim disputes to ensure if for example it is declined due to a pre-existing condition, to work with MGC to establish if member previously obtained treatment.
Multiply Visa Card
Liaise with the relevant department to establish issues with declined transaction on a MVC, Activation queries
Updating of CDI for Multiply Visa Card
Assisting with enquiries received from Money Management operations Team. This could include querying suspension, recently sending
proof of address and ID copies, confirming membership details on our record, contacting members to activate a HealthSaver account, investigating at what point member applied for MVC, queries regarding employer ruling
Neal currently assists with initiating project to route calls for MVC, assisting with reporting and interpretation, an addition to actually doing the escalations from the line.
Health-Saver
Assisting with HealthSaver balance checks after HealthReturns payment run.
Confirm transactions emanating from Multiply Visa Card.
Liaise with the billing department with regards to payment allocation and up-liftment of suspension of Health-Saver account.
Escalating to Finance Department for approval of Health-Booster backdated payments being credited to members account.
Review early release requests submitted for HealthSaver and approval if all mandatory requirements are met.

REQUIREMENTS

Matric
Technical specialist and subject knowledge expert in field
Knowledge of Momentum Health would be an advantage
Knowledge of Oracle System
Minimum of 2 to 3 years client service experience
Fluent in English and proficient in Afrikaans
Must be able to pass apply and demonstrate knowledge of the healthcare environment
Excellent command of written communications (drafting of letters and responding to emails)

COMPETENCIES REQUIRED

Business Acumen
Client/ Stakeholder Commitment
Drive for Results
Leads Change and Innovation
Motivating and Inspiring Team
Collaboration
Impact and Influence
Self-Awareness and Insight
Diversity and Inclusiveness
Growing Talent

ADDITIONAL INFORMATION

Disclaimer:
Shortlisted candidates will be subject to the following statutory checks:
References
Criminal
Credit
Qualifications

LOCATION

Cornubia, Durban

Please submit your application via our Careers page on www.mmiholdings.co.za

Job id : , #70331, 19 views,

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