Healthcare Support Specialist

Metacom Careers; Muntinlupa; On-site; PHP 312,000 - 536,000; Full time

Benefits offered by this job

Performance Bonus

Incentives

HMO Health Insurance

Job Training

Professional Development

Government Mandated Benefits

Job summary

Metacom Careers in the Philippines is seeking an experienced Healthcare Customer Service Representative to support members of an international healthcare account.

You will handle inbound calls, provide benefits and eligibility information, assist with claims and pre-authorization requests, and ensure privacy and accuracy.

This hybrid role requires 2 years of BPO/call center experience and a college or associate degree; BS Nursing grads are not eligible.

Qualifications

• College graduate or associate graduate in any course.
• BS Nursing graduates are not eligible for this account.
• At least 2 years of call center/BPO experience.
• Experience handling international healthcare accounts, especially pre-authorization, benefits & eligibility, and claims.

Responsibilities

• Handle inbound calls and assist members with healthcare-related concerns and inquiries.
• Provide accurate information regarding benefits and eligibility.
• Assist members with claims-related concerns and inquiries.
• Handle and process pre-authorization (pre-auth) requests according to guidelines.
• Verify member information and eligibility.
• Explain healthcare benefits, coverage, and available services clearly and professionally.
• Document customer interactions and update account information accurately.
• Resolve concerns efficiently while maintaining high customer satisfaction.
• Follow company policies, healthcare account procedures, and data privacy guidelines.

Skills

Customer service

Analytical skills

Problem solving

Communication

Education

College or Associate degree

Job description

Hybrid - Muntinlupa 1-3 Yrs Exp Bachelor Full-time

Job Description

Employee Recognition and Rewards

Performance Bonus, Incentives

Government Mandated Benefits

Insurance Health & Wellness

HMO

Professional Development

Job Training, Professional Development

We are looking for experienced Healthcare Customer Service Representatives account. The successful candidate will provide excellent customer service and healthcare-related support to members of an international healthcare account.

Key Responsibilities

• Handle inbound calls and assist members with their healthcare-related concerns and inquiries.
• Provide accurate information regarding benefits and eligibility.
• Assist members with claims-related concerns and inquiries.
• Handle and process pre-authorization (pre-auth) requests according to established guidelines.
• Verify member information and eligibility.
• Explain healthcare benefits, coverage, and available services clearly and professionally.
• Document customer interactions and update account information accurately.
• Resolve concerns efficiently while maintaining a high level of customer satisfaction.
• Follow company policies, healthcare account procedures, and data privacy guidelines.

Qualifications:

• College Graduate or Associate Graduate, any course.
• BS Nursing graduates are not eligible for this account.
• At least 2 years of call center/BPO experience.
• Must have experience handling international healthcare accounts.
• Experience catering to members, particularly in pre-authorization, benefits & eligibility, and claims is required.
• Strong customer service, analytical, and problem-solving skills.
• Willing to work in a hybrid setup.

English Language Customer Service Problem Solving Organizational Skills