Member Care Lead - Service Excellence

Medicare Plus Inc.; Vincenzo A. Sagun; On-site; PHP 335,000 - 502,000; Full time

Benefits offered by this job

Health insurance

Opportunities for promotion

Job summary

Medicare Plus Inc. is seeking a Customer Care Specialist to handle member inquiries with empathy and accuracy. You will manage inbound/outbound calls, LOA creation, and claims status updates, coordinating with the Claims Department for verified information.

Channel coverage includes email and Viber, with strict adherence to response times and escalation protocols. You will document interactions in the system, participate in coaching, and support team adherence to processes and quality standards

Qualifications

• Handle inbound member calls with active listening and empathy.
• Accurately log inquiries and update case tracker with verified info.
• Escalate complex issues to floor lead promptly.

Responsibilities

• Receive and handle inbound member calls professionally.
• Conduct outbound follow-up calls and fulfill callbacks.
• Manage inquiries via email and messaging channels (e.g., Viber).
• Provide accurate information on benefits, coverage, and claims status.
• Escalate irate or complex cases to designated team members.
• Create LOAs for member consultations and approvals.
• Process APE and Dental benefit availments with providers.
• Support discharge coordination workflows with LOA and coverage details.
• Log into telephony system and maintain queue readiness at shift start.
• Maintain after-call work documentation within the time window.
• Adhere to timekeeping and break policies; participate in team activities.

Skills

Active listening

Empathy

Communication

Tools

PAB telephony system

HRIS

Job description

Medicare Plus Inc. is seeking a Customer Care Specialist to handle member inquiries with empathy and accuracy. You will manage inbound/outbound calls, LOA creation, and claims status updates, coordinating with the Claims Department for verified information.

Channel coverage includes email and Viber, with strict adherence to response times and escalation protocols. You will document interactions in the system, participate in coaching, and support team adherence to processes and quality standards