Hiring Alert: Healthcare Expert (PHP 39, 700 Offer)

MetHealth; Quezon City; On-site; PHP 223,200 - 334,800; Full time

Job summary

A healthcare services provider is seeking a Healthcare Expert in Quezon City to manage inbound and outbound calls regarding healthcare services and assist patients with inquiries. The role requires at least 1 year of experience in a healthcare BPO environment, with strong communication skills and knowledge of healthcare processes. This position demands adherence to compliance standards while delivering excellent customer service. Candidates should be willing to work onsite and adapt to shifting schedules.

Qualifications

• At least 1 year of experience in a healthcare account in a BPO setting.
• Knowledge of eligibility verification, claims, benefits, or billing processes.
• Willingness to work onsite and on shifting schedules.

Responsibilities

• Handle inbound and outbound calls related to healthcare services.
• Assist members, providers, and patients with inquiries.
• Document all interactions adhering to compliance standards.
• Review and verify patient/member information.
• Coordinate with internal departments for efficient resolutions.
• Explain healthcare policies and benefits to customers.
• Escalate complex cases as necessary.
• Meet key performance indicators for service quality.

Skills

Healthcare processes knowledge

Strong verbal English communication skills

Good computer navigation

Multitasking skills

Education

Completed at least 2 years in college

Job description

Healthcare Expert

Responsibilities

• Handle inbound and outbound calls related to healthcare services, insurance benefits, claims, and eligibility verification.
• Assist members, providers, and patients with inquiries regarding coverage, billing concerns, authorizations, and account status.
• Accurately document all interactions in the system while adhering to HIPAA and company compliance standards.
• Review and verify patient/member information to ensure data accuracy and confidentiality.
• Coordinate with internal departments (claims, billing, pharmacy, prior authorization teams) to resolve concerns efficiently.
• Explain healthcare policies, procedures, and benefits clearly to customers in a professional manner.
• Escalate complex or urgent cases to the appropriate team when necessary.
• Meet or exceed key performance indicators (KPIs) such as AHT, CSAT, quality scores, and first call resolution.
• Maintain updated knowledge of healthcare processes, policies, and industry regulations.
• Deliver excellent customer service while demonstrating empathy, patience, and strong communication skills.

Qualifications

• Completed at least 2 years in college (no back subjects preferred).
• With at least 1 year of experience in a Healthcare account (BPO setting).
• Knowledgeable in healthcare processes such as eligibility verification, claims, benefits, or billing.
• Strong verbal and written English communication skills.
• Good computer navigation and multitasking skills.
• Willing to work onsite and/or on shifting schedules (if required).
• Amenable to start ASAP.