Patient Care & Claims Specialist

Sagility Philippines B.V Branch; Quezon City; On-site; PHP 201,000 - 335,000; Full time

Job summary

Sagility Philippines B.V Branch is seeking a HealthCare Associate to handle inbound/outbound patient calls, investigate inquiries and maintain precise documentation. You will coordinate with facilities, payors, and collections agencies to resolve accounts and review claims with attention to demographic and insurance updates.

The candidate should have at least 6 months customer service experience, English proficiency, and relevant certifications.

Qualifications

• Graduate of a Bachelor's Degree without experience
• Graduate of an Associate Degree (2-year vocational course) with 6 months customer service experience
• College Undergraduate / (completed 2 years) with 6 months customer service experience
• Must have successful completion of English language proficiency training and have current and valid certification documentation.

Responsibilities

• Handle inbound/outbound patient calls for support
• Investigate and conduct root cause analysis for inquiries received from patients and patient representatives
• Responsible for accurately documenting steps taken and next steps needed to provide resolution
• Coordinate with facilities, payors and collections agency related to a patient account
• Review and resolve patient concerns, including demographic updates, insurance updates, resubmitting claims, payment processing / assistance, and collection cancellation notices
• Review patient accounts, claim information and Explanation of Benefits to enable quick resolution of patient issues
• Draft communications to patients, patient representatives, payors, and vendors as needed
• Assist in responding to legal and financial assistance requests
• Maintain various email accounts to ensure patient concerns are properly addressed in a timely manner
• Evaluate customer service processes and provide feedback on improvement plan
• Report on status of patient concerns, trends, and resolutions to the management team
• Understand the account's Business Strategy and managed care direction
• Utilize and be familiar with current system functions, applications and enhancements
• Maintain resource materials such as updated disks, paper reference
• Additional responsibilities include development and training of self and co-workers
• Suggest and share ideas for system improvement
• Experiments with and accepts new ideas in a positive and timely manner
• Must achieve and maintain the account's Key Performance Measures
• Provide exceptional customer service to callers over the phone and/or through correspondence
• Maintain a high level of professionalism towards peers and customers at all times
• Abide by and be familiar with all the policies and procedures set forth by the client, the company and the program
• Adhere to schedule and changes as advised by the immediate supervisor
• Perform tasks in an efficient and effective manner with regard to the delivery of service requirements required by the client, project or company

Skills

Customer service

Computer literacy

Typing

Problem solving

Attention to detail

Communication

MS Office

Root cause analysis

Quality assurance

Independence

Education

Bachelor's degree, no experience

Associate degree, 6 months CS exp

College undergrad, 2 years, 6 months CS exp

Tools

Microsoft Office

Job description

Sagility Philippines B.V Branch is seeking a HealthCare Associate to handle inbound/outbound patient calls, investigate inquiries and maintain precise documentation. You will coordinate with facilities, payors, and collections agencies to resolve accounts and review claims with attention to demographic and insurance updates.

The candidate should have at least 6 months customer service experience, English proficiency, and relevant certifications.