CS Inbound Advocate Level I

MedRisk; Philippines; On-site; PHP 240,000 - 480,000; Full time

Job summary

MedRisk in the Philippines is seeking a Customer Service Inbound Advocate Level I to support communication between our network providers and workers' compensation adjusters. The role tracks patient progress from initial evaluation to discharge, gathering case information and maintaining file integrity while communicating professionally with referring customers.

Responsibilities include triaging calls, managing multiple claims, updating data in MedRisk’s database, and ensuring HIPAA/URAC

Qualifications

• Minimum of 3 years of call center experience with both in-bound and out-bound calls.
• 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.

Responsibilities

• Triage incoming calls to provide excellent customer service to internal and external customers.
• Manage multiple claims and monitor case status with Network Providers and clients.
• Properly update all case related data to MedRisk’s database.
• Relay authorizations to providers with confirmations to the Adjuster and Nurse Case Manager.
• Collaborate with Outbound Advocates and Clinicians to manage utilization.
• Be knowledgeable about the client’s unique needs and respond appropriately.
• Build approachable, professional relationships with providers and referring customers.
• Ensure compliance with HIPAA and URAC guidelines.
• Maintain monthly Total Agent Availability goals and meet customer support standards.

Skills

Call center experience

Customer service

Communication skills

Multi-tasking

Detail oriented

Time management

Education

Bachelor’s Degree

Tools

Microsoft Word

Excel

Windows OS

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.

CS Inbound Advocate Level IJob 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
• Manage multiple claims and monitor case status by confirming patient attendance with Network Providers, and addressing any concerns regarding compliance
• Properly update all case related data to MedRisk’s database
• 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