HMO Coordinator

1 day ago


Cebu, Philippines InLife Health Care Full time

A HMO Coordinator or Member Relations Representative is responsible for providing administrative support to the Hospital Liaison Officers Department, ensuring effective customer service to insured members, and managing utilization of medical services. The role involves coordinating with Hospital Care Directors, accredited physicians, and provider personnel to build strong relationships and ensure smooth operations. Key responsibilities include assisting members during medical availments, resolving queries and complaints, and maintaining accurate records. The ideal candidate will have excellent communication and coordination skills, experience in insurance and BPO, and a strong understanding of healthcare policies and regulations. They will work in a hybrid environment, handling multiple tasks and priorities, and be accountable for meeting performance targets. The Coordinator will also be responsible for building a robust roster of accredited medical facilities, conducting initial claims screening, and monitoring claims for reimbursement. Strong analytical and problem-solving skills are essential to succeed in this role. The Coordinator will work closely with the Medical Services Division and Sales and Marketing Division to ensure seamless implementation of plan policies and effective utilization management. Experience handling healthcare accounts and a background in medical services is an advantage. The role requires a flexible schedule, with the ability to work 8:00 AM to 5:00 PM and adapt to changing priorities. The ideal candidate will be proactive, results-driven, and committed to delivering exceptional customer service. They must be able to work effectively in a fast-paced environment, prioritize tasks, and manage multiple projects simultaneously.


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