Customer Service Representative (Premium Healthcare)

SAGILITY PHILIPPINES B.V. BRANCH OFFICE; Philippines; On-site; PHP 279,000 - 446,000; Full time

Job summary

SAGILITY PHILIPPINES B.V. BRANCH OFFICE is seeking a Customer Service specialist to handle inbound and outbound calls and educate customers on US health plan benefits.

The role requires strong communication, listening, and problem-solving skills, with the ability to work independently in a fast-paced environment. The successful candidate will liaise with health plans, service centers, and other teams, delivering clear guidance and compassionate support to policy holders.

Qualifications

• Excellent communication skills in spoken and written word.
• Ability to listen and understand customers' needs.
• Creative problem-solving and analytical skills.
• Able to work independently in a fast-paced environment.

Responsibilities

• Provide high level service to inbound and outbound calls.
• Educate customers on US health plan benefit package.
• Investigate and resolve escalations and complaints using available resources.
• Follow up timely and communicate proactively to customers.
• Serve as liaison between customers, health plans, service centers and other areas.
• Must have thorough technical knowledge of assigned products and excellent communication skills.
• Deliver complex business resolution services via calls or portal messaging.
• Respond to inquiries from policy holders needing more information.

Skills

Active listening

Written & spoken communication

Creative problem solving

Independent work in fast-paced env

Tools

Microsoft Word

Outlook

Job description

Mandatory Skills:

• Proven ability to listen, understand customers current & future needs, and interpret information from others
• Excellent communication skills in the spoken and written word
• Creative problem-solving and analytical skills
• Proven ability to independently manage day in a fast-paced environment
• Proficiency in Word and Outlook

Roles & responsibilities:

• Responsible for providing high level of service to inbound calls, outbound calls
• Will educate customer on US health plan benefit package to enable optimal health outcomes.
• Investigates and resolves escalations, issues, and complaints by leveraging all available resources for self-service, including policies, procedures, and practices before reaching out to their supervisor. When knowledge articles are not available to guide next steps, the individual must autonomously and accurately determine the best solution or option for the customer.
• Highly organized with ability to follow-up timely and communicate proactively to customer and other necessary parties.
• May serve as primary contact and liaison between customers, health plans, service centers, and/or functional areas.
• Must have thorough technical knowledge of assigned products and excellent communication skills.
• Understands when to seek support by coaches and leadership for issue resolution.
• Requires the delivery of complex business resolution services in customer service via inbound calls and outbound calls or portal messaging to customers.
• Responds to inquiries from policy holders where additional information or research is needed.
• Must listen intently and have ability to interpret verbal cues from customers, using technical expertise and breadth of knowledge to determine most effective action or response.
• The position requires high level of compassion and empathy, excellent interpersonal skills, strong communication and comfortability in sharing intricate and/or difficult messages.
• Knowledge and understanding of customer service and business/operating processes and procedures required.
• Must be a champion of change and adapt well to frequent adjustments to procedures or guidance.

The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned.