Job Description

Introduction

Metropolitan is one of the oldest financial services brands in South Africa. With a 125-year legacy of serving the communities in which it operates, Metropolitan represents true empowerment in serving Africa's people through affordable financial solutions that create financial growth and security. Metropolitan operates in South Africa, but the brand is also present in 7 African countries including, Namibia, Botswana, Kenya, Ghana and Lesotho. Metropolitan provides financial wellness solutions that meet the needs of low-income clients, including funeral insurance, health, savings, hospital cash-back cover, retirement solutions and life insurance. www.metropolitan.co.za

Disclaimer

As an applicant, please verify the legitimacy of this job advert on our company career page.

Role Purpose

Responsible for processing claims and service-related transactions across digital channels (WhatsApp, Web, RPA). Ensures accurate and efficient execution while resolving digital outliers and supporting the service community in adopting digital-first solutions. Provides feedback to Seniors and Team Lead to enhance digital processes and client experience.

Requirements

Grade 12 with Maths / Accountancy/ NQF4 equivalent
Certificate in Digital Transformation or CX principles advantageous
3-5 years' experience in client engagement, client service, or claims environments
Process claims, service transactions, and policy adjustments within defined guidelines
Ensure first-call resolution for processed claims and service transactions
Handle RPA and chatbot exceptions and outliers, escalating issues as necessary
Support digital adoption initiatives and contribute to embedding client experience principles
Knowledge of Metropolitan products, policy benefits, exclusions, and legislative requirements
Understanding of risk-based claims assessment
Working knowledge of in-house systems and digital platforms, including WhatsApp and Web
Basic understanding of Insurance Products, Insurance Law, Compliance, Pension Funds Act, and Income Tax Act
Understanding of specific insurance legislation, including POPIA and TCF
Knowledge and understanding of claims assessment philosophy and medical underwriting

Duties & Responsibilities

Client Experience & Service Delivery:

Understand, apply and process all chatbot and RPA related service transactions aligned to standard process documents/guides, which includes, claims, withdrawals, and policy adjustments, etc accurately and efficiently.
Ensure first-call resolution (FCR) and completion of all transactions within SLA.
Respond to client and branch inquiries promptly, demonstrating empathy and emotional intelligence.
Handle all escalations and outliers with sensitivity, accuracy and aligned to business principles whilst keeping the client experience positive and keeping the client informed throughout the engagement.
Escalate unresolved or complex issues to Senior Specialist according to workflow and in line with escalation process.
Maintain accurate documentation of all transactions and communications for compliance and reporting.
Identify minor service issues or recurring challenges and provide feedback for improvement.
Support and drive service CSAT targets.
Build, strengthen and maintain relationships with Metropolitan key stakeholders and act as key contact to Clients and Branches regarding digital training, queries, and service requests.
Manage processing of claims and service-related transactions through digital channels.
Handle and resolve digital channel outliers to ensure seamless client journeys.
Drive client uptake and adoption of digital channels.
Train service teams on new digital service transactions and processes.
Provide insights to improve digital servicing processes and reduce friction.
Partner with optimization and transformation teams to embed sustainable improvements.
Track adoption, turnaround times, and client satisfaction in digital channels.


Digital Adoption:



Encourage clients and branches to use digital channels (chatbot, WhatsApp, web) for service requests.
Support digital channel users with troubleshooting and guidance, showing patience and understanding.
Provide input to BPO or IT teams on improvements to chatbot conversations and workflows.
Operationalize the strategic initiatives aimed at increasing digital adoption and client engagement whilst maintaining a good client experience.
Monitor usage and adoption trends within assigned scope and report findings.


Workflow & Exception Management:



Share knowledge and operational tips with colleagues to improve team performance.
Assist peers in understanding processing workflows, digital tools, and exception handling procedures.
Contribute to team learning by highlighting common errors and operational improvements.
Continuously build knowledge of claims processes, digital systems, and regulatory requirements.
Proactive training of all service staff including Contact Centre and CSO on all chatbot and RPA related workflows.


Risk Identification:



Identify opportunities to enhance cost effectiveness and increase operational efficiency.
Manage financial and other company resources under your control with due respect.
Provide input into the risk identification processes and communicate recommendations in the appropriate forum.


Coaching & Reporting:



Provide input to BPO team to enhancing chatbot conversations for Web, WhatsApp and social media platforms
Provide technical digital assistance to maintain and grow the digital footprint for the Digital Service Channel.


Client Services:



Provide input to BPO team to enhancing chatbot conversations for Web, WhatsApp and social media platforms
Provide technical digital assistance to maintain and grow the digital footprint for the Digital Service Channel.
Drive the uptake of usage over digital platforms.
Resolve escalated Digital claim and service queries and ensure queries are processed in a timeously manner.


Operational & Financial Responsibility:



Ensure adherence to internal controls, policies, and regulatory requirements in all processed transactions.
Flag potential fraud, irregularities, or process risks and escalate appropriately.
Identify opportunities for operational efficiency and accuracy improvements.
Support resource optimization initiatives within operational scope.
First line liaison to group forensic services on flagged or identified fraud.

Competencies

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