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Medial Liaison Specialist

2 weeks ago

Mandaluyong City, National Capital Region, Philippines beBeeService Full time ₱150,000 - ₱250,000
Customer Service Representative Job Description

The Customer Service Representative will serve as a liaison between customers and our organization. Their primary responsibility will be to provide product and services information, coordinate with providers and facilities for member requests, answer questions, and resolve any emerging problems that our customers may face with accuracy and efficiency.

  • Accept inbound calls from members and accredited providers requesting for Letter of Authorizations. Address member concerns related to their health benefit program.
  • Ensure that LOA request is issued within the members' benefits based on their respective benefit matrices, remaining limits, and eligibility.
  • Conduct outbound calls as needed to assist with claim information or identify missing information.
  • Document all encounters in clear and concise logs.
  • Consistently meet individual performance standards/metrics.

This role requires strong communication (written and oral) and interpersonal skills, with the ability to work on shifting schedules and extend beyond operating hours when needed.

In terms of qualifications, we are looking for individuals with a Bachelor's Degree in a medical field or related degree, and at least 2 years of solid working experience in TPA, HMO, insurance, or insurance broker companies or BPO. Familiarity with health insurance/HMO policies and coverages is preferred.

Requirements:
  • Bachelor's Degree in medical field or related degree.
  • At least 2 years of solid working experience in TPA, HMO, insurance, or insurance broker companies or BPO.
  • Familiarity with health insurance/HMO policies and coverages.
  • Ability to work on shifting schedules and extend beyond operating hours when needed.
  • Amenable to work onsite as advised.