Support Service Specialist - Medical Allied Course

GROW Vite Staffing Services Inc.; Makati; On-site; PHP 223,200 - 334,800; Full time

Job summary

A healthcare staffing agency in Makati is seeking candidates for a customer experience role in the healthcare field. Responsibilities include monitoring admissions, creating cases in the system, and ensuring good relationships with providers. Ideal candidates will be graduates of medical-allied courses with communication skills, computer literacy, and a basic understanding of medical terms. Experience in healthcare or customer service is a plus.

Qualifications

• Experience in HMO, healthcare, or customer service is an advantage.
• Willing to do occasional outbound calls to providers.

Responsibilities

• Acknowledge admission for the day through active call-out.
• Monitor admissions in assigned/affiliated providers.
• Create case and authorization in One System; update discharge date.
• Call admitted member to reorient their benefit plan and requirements.
• Assess availment and issue Letter of Authorization accordingly.
• Establish good working relationships among affiliated providers.

Skills

Good communication skills (written and verbal)

Comfortable handling inquiries via digital and social media platforms

Basic knowledge of medical terms and procedures

Computer literate and detail-oriented

Education

Graduate of any medical-allied course

Job description

Qualifications

• Graduate of any medical‑allied course (e.g., Nursing, MedTech, Psychology)
• Experience in HMO, healthcare, or customer service is an advantage
• Good communication skills (written and verbal)
• Comfortable handling inquiries via digital and social media platforms
• Basic knowledge of medical terms and procedures
• Computer literate and detail‑oriented
• Willing to do occasional outbound calls to providers

Responsibilities

• Customer Experience
• Initially acknowledges admission for the day through active call‑out
• Closely monitors admissions in assigned/affiliated providers
• Creates case and authorization in One System; updates discharge date within 24hrs
• Calls admitted member and reorients benefit plan and requirements during admission; ensures understanding through acknowledgement of explanation if visit is not applicable
• Opportunity to expand services to attend members via hospital visits within hospital protocols
• Assesses availment and issues Letter of Authorization accordingly to billing/credit and collection
• Closely monitors members confinement progress through regular inquiry from available nurses on duty
• Calls member and attending physician whenever necessary
• May assist member during discharge to ensure proper computation and collection of uncoverable charges
• Captures provider issues such as unpaid claims, implementation of new hospital policies, threat of suspensions, etc.
• Establishes good working relationship among affiliated providers
• Utilization Management
• Reviews and analyzes cases of admission; checks necessity of the confinement and/or procedure
• Reviews and reports members Length of Stay (LOS) and cost of confinement and/or procedure
• Coordinates complex/catastrophic cases to superior or Medical Resource for proper management
• Approves coverage based on authority limit up to P50,000; otherwise refers to authorized approver
• Reports denied admissions
• Report Generation
• End of day report of admissions and discharge
• Updates the endorsement to claims in OS for claims reference
• Others
• Performs other tasks as may be assigned from time to time