Reference No: OCCA0925
An exciting position has become available at our Head Office in Cape Town. Suitably qualified applicants who possess the requirements listed below are encouraged to apply. SAMWUMED is committed to transformation in Southern Africa.
Job Purpose:
Operations Call Centre Agent is responsible for the inbound / outbound telephonic servicing of clients with the aim of providing a first call resolution experience, while maintaining a high standard of customer service
Key Responsibilities:
Client Service
- Manage large volumes of calls, ensuring timely and professional responses with in the 80 / 20 SLA.
- Provide clear and accurate information to members regarding their queries including claims status.
- Ensure Adherence with AHT, CSAT and FCR processes.
- Confirming benefits accurately and according to set protocols and funding rules and educating members accordingly.
Administrative Duties
- Maintain detailed records of customer interactions and transactions.
- Accurately update member / provider information on Nexus or relevant systems.
- Indexing of new or outstanding documents.
Escalations
- Correctly route escalated calls to the appropriate departments for resolution.
- Provide solutions and alternatives to ensure customer satisfaction
Quality Assurance
- Achieve and maintain a minimum quality standard of 90% on all member queries and interactions.
Compliance and Regulation
- Adhere to service level agreements (SLAs) and company policies, ensuring compliance with relevant regulations including ISO9001:2015 standards and POPI Act.
- Assist in fraud control, risk prevention, and compliance processes.
Minimum Requirements:
Education/Qualifications / Experience:
- Senior Certificate or relevant NQF level 4 qualification
- Call Centre or Customer Services Certificate/qualification advantageous
Experience
- 2-3 years’ experience in call centre or customer service role, preferably within the medical aid or healthcare sector.
- Proficient in MS Office (essential).
- Call Centre Knowledge in a Client and Service environment would be advantageous.
- Understand Claims, Tariffs, Ex-Gratia, CMS.
- Knowledge of Medical Schemes Act.
Capabilities:
- Communication Skills: Ability to communicate at all levels, both internally and externally
- Monitoring and Evaluation: Keeping abreast of all processes/benefit changes or updates. Continuously staying abreast of all digital servicing tools within the Scheme and ensuring that the functionality is fully understood.
- Time Management: Compliance with the department’s adherence to schedule
- Stakeholder Management: Ability to professionally engage with internal and external stakeholders
Persons interested in applying for the above position are requested to forward a comprehensive CV to recruitment@samwumed.org. Persons with disabilities are encouraged to apply.
The Closing date for applications is Monday, 22 September 2025
The Scheme reserves the right not to make an appointment. Should you not hear from us within two weeks of the closing date, please regard your application as unsuccessful.
Disclaimer:
Your personal data submitted will be dealt with on a strictly confidential and discreet basis and processed in relation to this job application and will be stored and processed securely in accordance with our data information policy and procedures. By submitting an application, you agree to your data being used, stored and processed for the purpose of recruitment.
