Medicare Claims Support Specialist

John Clements Consultants, Inc.; Taguig; Hybrid; PHP 279,000 - 502,000; Full time

Job summary

John Clements Consultants, Inc. is seeking a healthcare claims agent to handle inbound calls and deliver accurate assistance to customers navigating Medicare benefits. You’ll be the friendly point of contact bridging customers, providers, and the Claims Department.

You will document interactions in our ticketing system, meet response times, and support claims research using payer tools. A background in healthcare claims or call centers and solid communication skills are essential for success.

Qualifications

• 2–3 years of experience in healthcare claims operations and/or a call center.
• Knowledge of Medicare and Medicare Advantage plans.
• Strong written and spoken communication skills.

Responsibilities

• Receive and respond to inbound customer calls with prompt, accurate assistance.
• Make outbound calls as needed to follow up or resolve concerns.
• Document every customer interaction in our ticketing and tracking systems.
• Meet established service-level timeframes for customer inquiries.
• Act as the liaison between the Claims Department and healthcare providers.
• Research and investigate customer claims using primary payer systems.

Skills

Call center experience

Healthcare claims

Medicare knowledge

Communication skills

MS Word & Excel

Education

Bachelor's degree

Tools

Ticketing systems

Job description

John Clements Consultants, Inc. is seeking a healthcare claims agent to handle inbound calls and deliver accurate assistance to customers navigating Medicare benefits. You’ll be the friendly point of contact bridging customers, providers, and the Claims Department.

You will document interactions in our ticketing system, meet response times, and support claims research using payer tools. A background in healthcare claims or call centers and solid communication skills are essential for success.