Member Services Lead: 24/7 Support & Escalations

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

Job summary

Maxicare in Makati is seeking a customer care professional to support members with coverage decisions and inquiries. The role involves issuing Letters of Authority after coverage assessment and explaining non-coverage reasons to members.

Candidates should have at least 1 year of BPO experience in telco, financial, or healthcare CSR roles; BPO or HMO experience is advantageous. Willingness to work a rotating shift and support 24/7 operations is required.

Qualifications

• 1 year BPO experience in telco, financial, or healthcare CSR roles.
• BPO or HMO experience is an advantage.

Responsibilities

• Issues Letter of Authority after assessment of coverage, professionally explains non-coverage rationale to members.
• Screens assess and process availment cases based on procedures and benefit applications guidelines.
• Responds to inquiries and complaints at first-hand resolution (if possible) on customers’ feedback and issues raised.
• Escalates complex availment cases based on set escalation procedures.
• Complies to a pre-advised shift schedule and ensures to support Operations 24/7.
• Ensures operating costs reduction by proper use of office supplies/facilities including power, internet, and phones.

Job description

Maxicare in Makati is seeking a customer care professional to support members with coverage decisions and inquiries. The role involves issuing Letters of Authority after coverage assessment and explaining non-coverage reasons to members.

Candidates should have at least 1 year of BPO experience in telco, financial, or healthcare CSR roles; BPO or HMO experience is advantageous. Willingness to work a rotating shift and support 24/7 operations is required.