Call center Nurse

Lets Write Africa's Story Together!

Old Mutual is a firm believer in the African opportunity and our diverse talent reflects this.

Job Description

A Temporary employee in the Rest of Africa business.

Key Tasks and Responsibilities

•  Pre-Authorization of all admissions within 6 hours and technical guidelines.
• Minimize identifiable cases of fraud/abuse
• To resolve customer queries over the phone and offer solutions to the customers in a timely manner
• Supervise Pre-authorization of scheduled and non-scheduled admissions within the set guidelines and carry out verification and medical Audit of claims/invoices before settlement.
• Managing requests for services from providers, intermediaries and clients, providing information on the UAP Old Mutual provider network and available benefits per scheme policy
• In conjunction with SMART applications resolve card issues raised at the point of service
• Authorization of all optical requests from the different providers within 6 hours and prepare daily reports
• To attend to reimbursements from the different providers in a timely manner and provide daily reports.
• Liaise with other medical schemes for purposes of evaluating medical risk.

ANTI-MONEY LAUNDERING (AML) EXPECTATION

To formulate committal letters of discharges as a result of the requests from the different service providers.

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.

Qualifications: Minimum education:  

Degree/ Diploma in Nursing

Diploma in insurance

Skills and Competencies

• Excellent communication and negotiation skills
• To always keep time at the start of your shifts.
• Excellent public relations and interpersonal relationship skills
• Excellent networking with SP and other medical insurers
• Excellent analytical and monitoring skills
• Ability to work with speed and accuracy
• Strong Computer skills in Ms Word, Excel, Power Point and Ms Outlook
• Result – oriented, adheres to turn around times
• Strong teamwork spirit

Skills

Analytical Thinking, Call Center, Communication, Computer Literacy, Customer Due Diligence (CDD), Customer Queries, Daily Reporting, Due Diligence, Enhanced Due Diligence, Insurance, Interpersonal Relationships, Invoices, Know Your Customer (KYC), Microsoft Excel, Microsoft Outlook, Negotiation, Nursing, Point of Service, Public Relations (PR), Reimbursement, Risk Compliance, School Admissions, Teamwork, Verification

Competencies

Education

Diploma (Dip): Nursing (Required)

Closing Date

17 December 2025 , 23:59

The Old Mutual Story!