Experienced Customer Service Representative - Healthcare

Optum, a UnitedHealth Group Company; Muntinlupa; On-site; PHP 290,000 - 424,000; Full time

Benefits offered by this job

Medical Plan (HMO) from Day 1

Dental, Medical, and Optical Reimburse

Paid Time-Off Benefits

Tuition Reimbursement

EAP

Annual Merit Increases

Employee Referral Program

All Mandatory Statutory Benefits

Job summary

Optum in Alabang, Philippines seeks a Patient Care Coordinator to support patients through the financial clearance process before scheduled healthcare services. You will verify insurance coverage, obtain authorizations, explain financial responsibilities, and ensure all required information is accurately documented.

This role collaborates with patients, insurance providers, and healthcare teams to confirm eligibility, process MSP requirements where applicable, and communicate estimated patient

Qualifications

• At least a high school graduate or senior high school graduate.
• At least 1 year of experience in healthcare revenue cycle management.
• Experience in healthcare customer service or BPO operations.
• Experience with insurance verification or authorization.
• Experience with patient registration or patient access.
• Experience with medical billing or collections.
• Experience with healthcare payment collections in a voice-based environment.

Responsibilities

• Verify patient insurance eligibility, benefits, and coverage information.
• Obtain and validate required authorizations, referrals, and pre-certifications.
• Review medical necessity requirements and process applicable documentation when needed.
• Calculate and communicate estimated patient financial responsibility, including out-of-pocket costs.
• Contact patients to verify demographic, insurance, and financial information.
• Educate patients regarding insurance benefits, billing processes, payment options, and financial assistance programs.
• Collect payments and assist patients with payment arrangements when appropriate.
• Complete MSP requirements and related documentation.
• Maintain accurate and complete patient records in accordance with organizational standards.
• Follow healthcare compliance requirements, privacy regulations, and data security protocols.
• Escalate accounts that do not meet financial clearance requirements.
• Deliver exceptional customer service while addressing patient inquiries and concerns.

Skills

Healthcare RCM

Healthcare customer service

Insurance verification

Patient registration

Medical billing

Health insurance services

Payment collections (voice)

Education

High school diploma or equivalent

Job description

Patient Care Coordinator

Location: 12th Flr. Vector 3 bldg. Northgate Cyberzone Alabang Muntinlupa
Schedule: Night Shift (US Hours)

About the Role

We are looking for a detail-oriented and customer-focused Patient Care Coordinator to support patients throughout the financial clearance process before scheduled healthcare services. In this role, you will work closely with patients, insurance providers, and healthcare teams to verify insurance coverage, secure authorizations, explain financial responsibilities, and ensure all required information is accurately documented.

This position is ideal for professionals with experience in healthcare customer service, revenue cycle operations, insurance verification, patient registration, collections, or related healthcare support functions.

Key Responsibilities

• Verify patient insurance eligibility, benefits, and coverage information.

• Obtain and validate required authorizations, referrals, and pre-certifications.

• Review medical necessity requirements and process applicable documentation when needed.

• Calculate and communicate estimated patient financial responsibility, including out-of-pocket costs.

• Contact patients to verify demographic, insurance, and financial information.

• Educate patients regarding insurance benefits, billing processes, payment options, and financial assistance programs.

• Collect payments and assist patients with payment arrangements when appropriate.

• Complete Medicare Secondary Payer (MSP) requirements and related documentation.

• Maintain accurate and complete patient records in accordance with organizational standards.

• Follow healthcare compliance requirements, privacy regulations, and data security protocols.

• Escalate accounts that do not meet financial clearance requirements.

• Deliver exceptional customer service while addressing patient inquiries and concerns.

Qualifications

Required

• At least a high school graduate or senior high school graduate

• At least 1 year of experience in any of the following:

  • Healthcare Revenue Cycle Management (RCM)

  • Customer service in healthcare BPO operations

  • Insurance verification or authorization

  • Patient registration or patient access

  • Medical billing or collections

  • Health insurance services

  • Healthcare payment collections in a voice-based environment

Preferred

• Experience using electronic medical record (EMR) systems such as Epic or Cerner.

• Knowledge of U.S. healthcare insurance plans, benefits, eligibility, and coverage verification.

• Understanding of medical terminology, ICD-10, and CPT codes.

• Experience with payment processing and financial counseling.

• Familiarity with charity care and patient financial assistance programs.

• Proficiency in Microsoft Office applications, including Excel, Word, and Outlook.

Work Arrangement

• Must be willing to work onsite in Alabang.

WHAT WE OFFER:

Market Competitive Pay Levels

Retirement Plan

Medical Plan (HMO) from Day 1 of employment

Dental, Medical, and Optical Reimbursements

Life and Disability Insurance

Paid Time-Off Benefits

Sick Leave Conversion

Tuition Reimbursement

Employee Assistance Program (EAP)

Annual Performance Based Merit Increases

Employee Recognition

Training and Staff Development

Employee Referral Program

Employee Volunteerism Opportunity

All Mandatory Statutory Benefits

WHO WE ARE:

Optum is the health care technology and innovation company of the UnitedHealth Group enterprise along with UnitedHealthcare.

UnitedHealth Group is a health care and well-being company with a mission to help people live healthier lives and help make the health system work better for everyone.

We're a leading health solution and care delivery organization. Our work is complex, but our mission is simple: create a healthier world, with you at the center.

As part of a Fortune 5 enterprise, we are improving the health care experience of over 125 million people around the world.

Elevate your career with a leading health care company while improving lives.

Join us in evolving health care so everyone can have the opportunity to live their healthiest life. This is your opportunity to be part of a team that's dedicated to Caring. Connecting. Growing together.