Customer Service Representative - Healthcare

Apply Superstaffjobs; Angeles; Hybrid; PHP 184,000 - 273,000; Full time

Benefits offered by this job

HMO

Life Insurance

Night Differential

PTO Credits

Laptop Provided

Career Growth

Company Culture

Merit Increases

Job summary

Apply Superstaffjobs is seeking a Customer Service Representative to handle inbound and outbound calls, resolve member and provider questions, and ensure accurate health share information in line with Membership Guidelines.

The role involves reviewing medical records, explaining eligibility details, and collaborating across departments to deliver excellent service. Onsite in the Philippines with potential transition to remote work after initial period.

Qualifications

• High school diploma or GED required.
• At least 1 year of customer service experience.
• Healthcare experience preferred (reviewing and/or verifying medical records).
• Associates or higher degree preferred.

Responsibilities

• Answer incoming calls from members and providers and follow-up with outbound calls as necessary.
• Resolve general member and provider issues by phone or email.
• Identify and escalated issues as necessary.
• Provide accurate health sharing information and service to members and providers.
• Obtain and review medical records as necessary.

Skills

Critical thinking

Excellent communication

Self-motivated

Teamwork

Strong computer skills

Phone etiquette

Education

High School Diploma or GED

Associates or higher degree preferred

Tools

Google Suite

Salesforce

Call center software

Outlook

Job description

The Customer Service Representative will take inbound and make outbound calls regarding specified requests, common questions and pursue one call resolution for health share members and providers. The Customer Service Representative works with all departments to ensure that members and providers receive accurate health share information as determined by the Membership Guidelines.

Essential Duties:

• Answer incoming calls from members and providers and follow-up with outbound calls as necessary.
• Resolve general member and provider issues by phone or email.
• Identify and escalated issues as necessary.
• Recognize and document trends or problems that may arise in operations and alert management when needed.
• Provide accurate health sharing information and service to members and providers.
• Obtain and review medical records as necessary.
• Ensure member information and eligibility is accurate and up to date.
• Explain detailed information regarding eligibility to both members and providers.
• Is coachable and willing to learn.
• Capable of providing the greatest customer service experience possible.

Skills Required:

• Critical thinking and problem-solving skills
• Self-motivated, goal-oriented individual
• Excellent written, verbal, and interpersonal communication skills
• Work independently and in a team environment
• Strong computer skills and working knowledge of Microsoft Outlook
• Excellent phone etiquette and customer service skills as majority of time will be spent on the phone
• Familiarity with medical policies and procedures and HIPPA

Requirements

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education/Experience:

• High School Diploma and/or GED required

• At least 1 year of customer service experience required
• Healthcare experience preferred (reviewing and/or verifying medical records)
• Associates or higher degree preferred

Technical Knowledge:

• Google Suite including Share Drives, Email and Internet
• Call center phone software and/or operating systems
• Salesforce knowledge preferable

Benefits

• HMO with 1 free dependent upon hire
• Life Insurance
• 10% Night Differential
• 20 PTO credits annually
• VL and SL cash conversion
• Annual Performance-Based Merit Increases and Employee Recognition
• Great Company Culture
• Career Growth and Learning
• A laptop will be provided by the company
• 20,500PHP basic + allowances
• Onsite (Makati or SM Clark) on the first 6 months, then will transition to WFH
• 9:00 PM - 6:00 AM PHT (Weekends Off)