Urgent Hiring LOA/HMO Processor Specialist

Synctalents International Corporation; Makati; On-site; PHP 279,000 - 424,000; Full time

Benefits offered by this job

Paid training

Pay raise

Job summary

A recruitment agency in Metro Manila is seeking candidates for a full-time customer support role. Responsibilities include reviewing Letters of Authorization, verifying member policies, and addressing inquiries from members and healthcare providers. The ideal candidate is detail-oriented, has strong communication skills, and can thrive in both voice and non-voice accounts. Benefits include paid training and opportunities for pay raises.

Qualifications

• Fresh graduates are welcome to apply.
• Strong communication skills for member interactions.
• Attention to details for verifying policies and entitlements.

Responsibilities

• Review and evaluate Letters of Authorization requests.
• Verify member policies and benefits before authorization.
• Handle inbound and outbound communications regarding policy inquiries.
• Coordinate with underwriting and claims teams for complex issues.
• Document customer interactions and authorization activities.
• Identify potential issues or fraud.
• Identify potential issues or fraud and escalate to management.
• Meet or exceed daily productivity and quality standards.
• Participate in process improvements and customer experience initiatives.

Skills

Customer service

Communication skills

Attention to detail

Problem solving

Job description

1. Review and evaluate Letters of Authorization (LOA) requests in accordance with member eligibility and policy coverage.

2. Verify member policies, benefits, and entitlements in the system prior to authorization.

3. Approve or decline requests based on company guidelines, policy terms, and service level agreements (SLAs).

4. Handle inbound and outbound calls or emails from members, hospitals, and partners regarding policy coverage, LOA status, and related inquiries.

5. Coordinate with underwriting and claims teams for complex or exceptional cases.

6. Ensure accurate and timely documentation of all customer interactions and authorization activities.

7. Identify and escape issues, trends, or potential fraud to management.

8. Meet or exceed daily productivity and quality standards.

9. Participate in continuous process improvement initiatives and promote a positive customer experience

Job Types: Full-time, Permanent, Fresh graduate, Voice and Non-Voice Account

Benefits:

• Paid training
• Pay raise