Customer Service Representative - Healthcare

SuperStaff Outsourcing

Makati

Hybrid

PHP 208,000 - 249,000

Full time

5 days ago

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Benefits offered by this job

HMO with 1 free dependent

Life Insurance

10% Night Differential

20 PTO credits annually

VL and SL cash conversion

Annual Merit Increases and Employee 5%

Great Company Culture

Career Growth and Learning

Laptop provided

Onsite (Makati or Clark) then WFH

Job summary

SuperStaff Outsourcing is seeking a Customer Service Representative in Metro Manila to handle inbound and outbound calls for health share members and providers. You will resolve issues by phone or email, review medical records, and ensure eligibility information is accurate.

Any background in healthcare and familiarity with HIPAA will support success in this role. Onsite at Makati initially, transitioning to WFH with a strong customer service focus.

Qualifications

High School Diploma or GED required.
At least 1 year of customer service experience required.
Healthcare experience preferred (reviewing and/or verifying records)

Responsibilities

Answer incoming calls from members/providers and follow up with outbound calls as necessary.
Resolve general member and provider issues by phone or email.
Identify and escalate issues as necessary.
Document trends or problems and alert management when needed.
Provide accurate health sharing information to members/providers.
Obtain and review medical records as necessary.
Ensure member information and eligibility is accurate and up to date.
Explain detailed eligibility information to members/providers.

Skills

Critical thinking

Self-motivated

Clear communication

Team player

Microsoft Outlook

Phone etiquette

HIPAA knowledge

Healthcare familiarity

Education

High School Diploma

1+ year customer service

Associates or higher degree preferred

Tools

Google Suite

Call center software

Salesforce

Job description

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 escalation 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

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