Member Service Advocate

5 days ago

Pasig, National Capital Region, Philippines beBeeService Full time ₱25,000 - ₱35,000

Job Opportunity: Member Service Advocate

">Job Description:

The Member Service Advocate acts as a liaison, providing product and service information to members. They coordinate with healthcare providers and facilities to resolve member requests, answer questions, and address emerging problems.

">Key Responsibilities:
  • Respond to inbound calls from members and healthcare providers requesting letter of authorizations.
  • Address member concerns related to their health benefit program.
  • Issue LOAs within member benefits based on benefit matrices, remaining limits, and eligibility.
  • Conduct outbound calls to assist with claim information or identify missing information.
  • Document encounters in clear logs.
  • Meet individual performance standards/metrics.
Requirements:
  • Bachelor's degree in a medical field or related degree.
  • Two years of experience in TPA, HMO, insurance, or BPO.
  • Familiarity with health insurance/HMO policies and coverages.
  • Ability to work flexible schedules and extended hours.
  • Amenable to working onsite as advised.
  • Strong attention to detail, communication, and interpersonal skills.
  • Organized and able to work with minimal supervision.
  • Proficiency in MS Office (Excel, Word, PowerPoint) and/or G-Suite Tools.
Work Setup:

Location: Greenfield District, Mandaluyong City

Work Schedule: 11PM - 7:00AM; Hybrid (subject to change)

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