Inpatient Services Lead — Member Coverage & Care Coordination

Maxicare; Makati; On-site; PHP 279,000 - 391,000; Full time

Job summary

Maxicare in Makati is seeking a Customer Care professional with 2–5 years of experience to review LOAs, explain coverage during MAG discussions, and address escalations with internal partners. The role supports the team’s goals by processing requests, guiding members to Maxicare networks, and delivering accurate reporting.

Occasional campaign tasks may be required. Candidate will work under supervision with the Customer Care Department, ensuring smooth operations and responsive service to

Qualifications

• 2–5 years of experience in a similar role or relevant field.
• Experience handling LOAs, eligibility and coverage details.

Responsibilities

• Review, evaluate, and process Letters of Authorization (LOA) with minimal supervision.
• Analyze escalations related to eligibility, coverage, and procedures with internal/external partners.
• Offer first-hand solutions for complaints and route to appropriate internal teams.
• Guide members to Maxicare networks and partners, highlighting exclusive benefits.
• Prepare reports with accurate data and support team goals.
• Contribute to campaigns and tasks during manpower shortages or low SL periods.

Skills

LOA review & processing

Coverage explanation

Escalation handling

Customer guidance & support

Reporting & data accuracy

Job description

Maxicare in Makati is seeking a Customer Care professional with 2–5 years of experience to review LOAs, explain coverage during MAG discussions, and address escalations with internal partners. The role supports the team’s goals by processing requests, guiding members to Maxicare networks, and delivering accurate reporting.

Occasional campaign tasks may be required. Candidate will work under supervision with the Customer Care Department, ensuring smooth operations and responsive service to