Patient Care & Claims Support Specialist

SAGILITY PHILIPPINES B.V. BRANCH OFFICE; Philippines; On-site; PHP 279,000 - 446,000; Full time

Job summary

Sagility Philippines B.V. Branch Office is seeking a HealthCare Associate to handle inbound/outbound patient calls, document interactions, and coordinate with facilities, payors, and collections agencies in Quezon City. The role emphasizes accurate records, quick resolutions, and a focus on quality service.

You will conduct root-cause analyses, review claims and EOBs, and draft communications to patients and vendors while maintaining professionalism and adherence to client policies.

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

Responsibilities

• Handle inbound/outbound patient calls for support.
• Investigate and conduct root cause analysis for inquiries received from patients.
• 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, which include: 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.
• Maintains resource materials such as updated disks, paper reference
• Additional responsibilities include development and training of self and co-workers
• Suggest and shares ideas for system improvement
• Experiments with and accepts new ideas in a positive and timely manner
• The Healthcare Associate 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 Orientation

Computer Literacy

Job Knowledge

Sense of Urgency

Passion for Excellence

Work Organization

Product Knowledge

Typing/Computer Skills

Problem Solving

Decision Making

Root Cause Analysis

Customer-Centric Mindset

Independence

MS Office Proficiency

Communication Skill (Oral)

Communication Skill (Written)

Relationship Building

Attention to Detail

Education

Bachelor's Degree

Associate Degree (2-year) with 6 months CS experience

College Undergraduate / completed 2 years with 6 months CS experience

Tools

Microsoft Office

Internet Resources

Job description

Sagility Philippines B.V. Branch Office is seeking a HealthCare Associate to handle inbound/outbound patient calls, document interactions, and coordinate with facilities, payors, and collections agencies in Quezon City. The role emphasizes accurate records, quick resolutions, and a focus on quality service.

You will conduct root-cause analyses, review claims and EOBs, and draft communications to patients and vendors while maintaining professionalism and adherence to client policies.