CS Inbound Advocate Level I

f139a240-55be-4f9c-8b7e-f3b1668371c2; Mandaluyong; On-site; PHP 240,000 - 360,000; Full time

Job summary

MedRisk is seeking an Inbound Advocate Level I to support communication between network providers and referring workers' compensation adjusters. The role focuses on tracking patient progress, maintaining case files, and delivering professional, accurate data to clients.

The successful candidate will handle high-volume inbound/outbound calls, maintain HIPAA/URAC compliance, and collaborate with clinicians to optimize utilization while upholding service and quality standards.

Qualifications

• Three years of call center experience (inbound/outbound) required.
• Bachelor's degree preferred or equivalent experience.
• Impeccable customer service skills and professional communication.
• Ability to multitask in a fast-paced environment.
• Detail oriented with strong organizational skills.

Responsibilities

• Triage incoming calls to provide excellent customer service to internal and external customers.
• Manage multiple claims and monitor case status with providers and adjusters.
• Update all case data in MedRisk’s database accurately.
• Relay authorizations to providers per client directions with confirmations to adjusters and nurse case managers.
• Collaborate with outbound advocates and clinicians to manage utilization.
• Ensure compliance with HIPAA and URAC guidelines and meet service standards.

Skills

Customer service

Communication

Microsoft Word/Excel

Windows

Time management

Education

Bachelor's degree preferred

Tools

Microsoft Word

Excel

Job description

Job Description:

CS Inbound Advocate Level I

Job Description

Customer Service Inbound Advocate Level I

Inbound Advocates support the communication between our MedRisk Network Providers and the referring Workers Compensation Adjusters/Nurse Case Managers. Acting as liaison, an Inbound Advocate tracks patient progress from the Initial Evaluation to discharge by obtaining relevant case information from Providers, maintaining the integrity of the case file and related documents, and communicating professionally and effectively with the referring customer. Inbound Advocates help strengthen MedRisk’s referral process ensuring efficient workflow while increasing customer satisfaction.

Primary Duties & Responsibilities

• Triage incoming calls to provide excellent customer service to internal and external customers
  1. Manage multiple claims and monitor case status by confirming patient attendance with Network Providers, and addressing any concerns regarding compliance
  2. Properly update all case related data to MedRisk’s database
  3. Track and relay authorization to our providers as directed by the clients with confirmations to the Adjuster and Nurse Case Manager
• Work closely with the Outbound Customer Advocates and the Clinicians to manage utilization
• Be knowledgeable regarding the client’s unique needs and respond appropriately
• Build approachable, professional relationships with providers and referring customers.
• Compliance with HIPAA and URAC guidelines
• Maintain TAA goal (Total Agent Availability) monthly.
• Consistently meet MedRisk Customer Support Service & Quality standards (call monitoring and COID monitoring)

Qualifications

• Minimum of 3 years of call center experience with both in-bound and out-bound calls (medium to high volume).
• Bachelor’s Degree preferred or industry experience equivalent
• Impeccable customer service skills
• Ability to multi task in a fast paced environment
• Detail oriented
• Excellent communication skills
• Knowledge of Microsoft Word and Excel
• Computer skills in Windows environment
• Time management and strong organizational skills