Care Officer – Call Centre at GA Insurance

Care Officer – Call Centre at GA Insurance – GA Insurance Kenya Job Details

About the Role

GA Insurance is recruiting a Care Officer – Call Centre to join its customer service team in Nairobi. This is a full-time position responsible for delivering consistent, high-quality customer support across all inbound and outbound interactions. With over 50 years of experience in general insurance underwriting, GA Insurance manages medical, travel, and other risk classes. The Care Officer – Call Centre role sits at the front line of member engagement, handling queries, claims coordination, and benefit guidance.

The position requires a healthcare-qualified professional with insurance industry knowledge and at least two years of call center or customer care experience. You’ll work within defined service level agreements, manage escalations, and coordinate with medical professionals and brokers to resolve member issues efficiently.

Key Responsibilities

• Handle incoming calls from members regarding policy eligibility, claim status, benefit details, and payment information.
• Process medical pre-authorizations, admissions, discharges, and claim declines in line with policy provisions and authority limits.
• Resolve escalated issues received via phone or email within agreed service timelines to maintain member satisfaction.
• Coordinate with healthcare providers, insurance brokers, and members to facilitate patient admissions and treatment approvals.
• Advise members on optimal benefit utilization, including cost-effective facilities and available packages such as maternity or chronic disease management programs.
• Log claims into the system promptly and monitor email response turnaround times.
• Refer high-value admissions and discharges exceeding your authorization limits to the care nurse or senior officer.
• Receive and document member complaints, follow up within service level agreements, and communicate resolution updates.
• Identify service gaps and provide feedback on corrective measures to improve operational processes.

Requirements & Qualifications

• Bachelor’s degree or diploma in Nursing (KRCHN), Clinical Medicine & Surgery, Health Management, or related healthcare field.
• Current registration with the Kenya Nursing Council as a Registered Nurse or Registered Community Health Nurse.
• Minimum two years of experience in a similar care management or customer service role within the insurance or healthcare sector.
• Proficiency in Microsoft Office applications and knowledge of medical terminology relevant to insurance claims and benefits.
• Understanding of insurance industry concepts, regulatory requirements, and customer relationship management principles.
• Demonstrated ability to manage multiple customer interactions simultaneously while maintaining accuracy and attention to detail.
• Strong analytical and problem-solving skills with the ability to work independently or collaboratively as required.
• High emotional intelligence, integrity, and dependability in handling sensitive member information.

What to Expect

• A structured call center environment with defined workflows, quality standards, and compliance requirements under the Data Protection Act.
• Regular interaction with healthcare professionals, brokers, and members across multiple communication channels (phone, email, system updates).
• The opportunity to use your healthcare qualification and insurance knowledge in a customer-facing role that directly impacts member outcomes.
• This Care Officer – Call Centre at GA Insurance position in Nairobi is open to qualified candidates. Click Apply below to submit your application.