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Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.
Job Description
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The Contact Centre Clinical Executive is responsible for delivering efficient, accurate, and professional customer support through multiple communication channels, including phone calls, email, and other available platforms.
1. KEY TASKS AND RESPONSIBILITIES
- Answer all incoming calls professionally, providing support for a wide range of enquiries
- Respond to all email enquiries and approval requests to the assigned email addresses within agreed turn around time
- Manage evacuation and ambulance requests efficiently and promptly
- Collaborate with providers and the Case Management team to manage admissions and discharges of Old Mutual members
- Process pre-authorization requests for outpatient, dental, and optical services, ensuring quality and cost-efficiency
- Mitigating risk-ensure proper adjudication of pre authorizations / claims in line with the Old Mutual policies, e.g. enforcing of waiting periods among other terms and conditions
- Collaborate with providers and clients to identify cost-effective options and implement key initiatives that maximize value for our members
- Offer detailed and accurate information about Old Mutual’s provider network, policy terms, and available services
- In conjunction with Smart applications resolve smart access issues raised at the point of service
- Maintain accurate and timely documentation of all interactions and services provided
- Escalate / liaise with claims/ care teams on any issues which require further consultation
- Participate in all required training sessions and departmental meetings
- Perform general contact centre duties, including customer surveys, social media, and email management
- Performs all other tasks as assigned by the Contact Center Manager or the Quality Assurance Supervisor
2. SKILLS AND COMPETENCIES
- Communication Skills: Clear, concise, and courteous verbal and written communication
- Problem Solving: Able to assess issues quickly and take appropriate action or escalate where necessary
- Attention to Detail: Ensures accuracy in processing requests and documenting interactions
- Teamwork and Collaboration: Works effectively with internal teams (e.g. BPU, Relationship managers, case management, claims), Intermediaries and external service providers
- Customer Service Excellence: Demonstrates professionalism, empathy, and efficiency in all client interactions
- Technical skills: Proficiency in handling contact centre systems (e.g., telephony, CRM platforms, email management tools)
4. KNOWLEDGE & EXPERIENCE
- Strong understanding of clinical guidelines, healthcare processes, and insurance policy application
- Knowledge and experience in customer experience delivery
5. QUALIFICATIONS
- Bachelor’s Degree or Diploma in Clinical Medicine, Nursing, or a related healthcare field. ✓ Diploma or certification in Insurance Proficiency is an added advantage
6. ANTI-MONEY LAUNDERING (AML) EXPECTATION
The incumbent will be responsible for ensuring adherence to, implementation of, and adoption of Compliance, Anti-Money Laundering (AML), and Sanctions-related policies, procedures, and process requirements within Old Mutual and its subsidiaries. This includes execution of customer due diligence processes, ensuring compliance with Know-Your-Customer (KYC) standards, conducting ongoing and enhanced due diligence, and maintaining data quality. Additionally, the role involves identifying and monitoring potential AML, Sanctions, or Compliance breaches and unusual activities, and escalating these concerns to the Risk and Compliance Office for further action.
Skills
Consultative Selling, Customer Complaint Management, Customer Feedback Management, Customer-Focused, Customer Relationship Management (CRM) Software, Customer Service, Customer Service Operations, Customer Understanding, Data Management, Digital Consumer Engagement, Identifying Sales Opportunities, Probing Questions, Sales Data Management, Strengthening Customer Relationships, Upselling
Competencies
Action Oriented
Communicates Effectively
Customer Focus
Decision Quality
Ensures Accountability
Instills Trust
Interpersonal Savvy
Nimble Learning
Education
NQF Level 3 & NQF Level 2 - Below school leaving
Closing Date
01 April 2026 , 23:59
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