Customer Care Representative

Valor Global, Inc.; Biñan; Presencial; PHP 201.000 - 312.000; Jornada completa

Descripción de la vacante

Valor Global, Inc. in the Philippines (Laguna region) seeks a Healthcare Member Services specialist to support members with plan coverage, benefits, and enrollment, delivering clear explanations and empathetic service.

You will review medical billing statements, investigate discrepancies, and document member interactions across multiple healthcare data platforms, while adhering to HIPAA and security policies. 1–2 years in healthcare BPO preferred, Salesforce experience advantageous.

Formación

• 1–2 years in a BPO environment handling healthcare member services.
• Experience with Benefits & Claims, Billing & Enrollment, or both.
• Experience with medical billing terminology.
• Proficiency in CRM systems; Salesforce preferred.
• Strong English verbal and written communication.
• High school diploma required; higher degree preferred.

Responsabilidades

• Serve as frontline support for healthcare members, answering inquiries regarding plan coverage, benefits, and enrollment with empathy and clarity.
• Review, investigate, and explain complex medical billing statements, claims statuses, and payment discrepancies to members.
• Research and document all member interactions accurately across multiple data platforms and healthcare databases.
• Maintain strict adherence to HIPAA and company security protocols during every interaction.

Conocimientos

Healthcare Member Services

Benefits & Claims

Billing & Enrollment

CRM systems

Salesforce

English communication

Multitasking

Data privacy

Educación

High School Diploma or equivalent

Associate's or Bachelor's degree preferred

Herramientas

Salesforce

Descripción del empleo

Key Responsibilities

• Serve as the frontline support for healthcare members, answering inquiries regarding plan coverage, benefits, and enrollment with empathy and clarity.

• Review, investigate, and explain complex medical billing statements, claims statuses, and payment discrepancies to members.

• Research and document all member interactions accurately across multiple data platforms and healthcare databases.

• Maintain strict adherence to healthcare privacy regulations (HIPAA) and company security protocols during every interaction.

Core Qualifications & Requirements

• Minimum of 1-2 years of experience in a BPO environment specifically handling Healthcare Member Services.

• Direct experience managing Benefits & Claims, Billing & Enrollment, or a combination of both.

• Solid foundational knowledge and hands-on experience handling medical billing processes and terminology.

• Proven background using CRM systems to log and manage customer files; Salesforce experience is highly preferred.

• Strong technical aptitude with the ability to learn complex proprietary software quickly, troubleshoot basic connectivity issues, and seamlessly multitask across dual monitors and multiple open applications.

• Excellent verbal and written English communication skills, with a proven ability to explain complex insurance concepts in simple terms.

• High School Diploma or equivalent required; Associates or Bachelor's degree preferred.