Field Customer Service Specialist 1

Asalus Corporation (IntelliCare); Metro Manila; On-site; PHP 201,000 - 312,000; Full time

Job summary

Asalus Corporation (IntelliCare) is seeking a customer service professional to delight members with quality, personalized assistance for HMO availments at company premises or assigned locations. You will ensure proper implementation of SLAs and benefit plans while contributing to client retention.

Responsibilities include acting as help desk via hotlines, in-person, and email; endorsing and approving procedures; guiding reimbursements; coordinating with ECU/APE and HR teams; and assisting

Qualifications

• 4-year allied medical degree or acceptable equivalent
• Experience as a customer service representative

Responsibilities

• Provide accurate and timely assistance to clients
• Answer inquiries via hotlines, face-to-face, and email
• Process RCS 1 and 2 within Authority
• Endorse reimbursement to facilities and PRO
• Assist in Philhealth filing and documentation
• Coordinate with ECU/APE and HR for scheduling and document handling

Skills

Customer service

Communication skills

Attention to detail

Adaptability

Education

4-year allied medical degree

Tools

Microsoft Office

Job description

JOB PURPOSE

To delight customers by providing quality service through personalized assistance of members at the company premises or other assigned locations for any HMO related availments. Ensure proper implementation of the service level agreement and benefit plan of the members and contribute to client retention.

DUTIES & RESPONSIBILITIES

Build and establish good relationship with the client by giving accurate and timely assistance.

• Act as help desk to companies by answering inquiries & concerns through hotlines, face to face and e-mails.
• Issuance of RCS 1 and 2 within their Levels of Authority.
• Providing approvals and/or disapprovals of the requested procedures.
• Endorsement of members availment to facilities for outpatient and to assigned PRO for confinement.
• Remind members in filing of Philhealth.
• Conducts initial screening of reimbursement documents and give timely feedback on the following.
• Status of file reimbursement.
• Lacking documents.
• Approved amount reimbursable.
• Release date of approved reimbursement.

To ensure proper implementation of cost management initiatives within the company he/she is assigned to, to affect the company’s bottom line.

• Steering members to Cost Efficient facilities by following below process:
• Referral to company doctors
• Referral to Telemedicine (Medgate & TelAventus)
• Aventus Clinics
• Other cost-efficient clinics/providers and recommended panel of doctors.
• Accredited Hospitals.
• To prevent fraud and abuse of the members by following the adjudication process.

To ensure delivery of best customer experience to clients we serve and build loyalty and trust.

• Coordinates with the different responsibility centers to escalation complicated concerns.
• Issuance of Certificate of Coverage (COC).
• Coordinate with ECU/APE team for the following.
• Assists in setting of schedule.
• Receives ECU/APE result and endorse to HR.
• Monitors actual availment.
• Sort and distribute received HMO cards.
• Receive and screen documents for ID replacement request.
• Transmittal of documents to the respective responsibility center.
• Assist HR in accomplishing Philhealth documents.

QUALIFICATIONS

Educational Requirement

Candidate must possess at least 4-year college degree in allied medical course. Undergraduate of allied medical course or graduate of any non-medical course maybe accepted.

Relevant Work Experience

At least w/ experience as a customer service representative

Personal Characteristics and Behaviors

Ability to work in a shifting schedule. Deal w/ different types of personalities and work under pressure. With pleasing personality. Attentive to details. Flexible and can work effectively under pressure

Required Competencies and proficiency levels

Knowledge in medical terms, procedures and abbreviations, Computer literate.
Good in oral & written Communication skills, Computer literate.

NOTE

Office Address: Ground Floor, Feliza Building, 108 V.A. Rufino St., Legaspi Village, Makati City

Work Setup: Office-based during training. Work arrangement after training (office-based or fieldwork) will be determined based on operational requirements and manpower needs.