Clinical Support Specialist

14 hours ago

Calamba, Calabarzon, Philippines beBeeCustomer Full time $42,885 - $64,567
Job Overview

We are seeking a skilled professional to join our clinical support team. As a key member, you will play a crucial role in customer satisfaction by making every contact informative, productive, and positive for our members and providers.

You will have the opportunity to do live outreach, educating members about program benefits and services while also helping to manage member cases.

Main Responsibilities:

  • Manage the intake of members or admission/discharge information post notification
  • Work with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and/or providers
  • Manage the referral process, processing incoming and outgoing referrals and prior authorizations, including intake, notification, and census roles
  • Provide appropriate triage and care coordination notification cases for non-clinical assessment/intervention
  • Handle resolution/inquiries from members and/or providers
  • Ensure compliance with employment contract terms and conditions, company policies, and procedures
Key Requirements:
  • A high school diploma or equivalent
  • At least 1 year of customer service experience analyzing and solving customer problems
  • The ability to create, edit, save, and send documents using Microsoft Word and Excel
  • The ability to type and talk at the same time and navigate through multiple screens

This is a high-volume, customer-service environment that requires efficiency, productivity, and thoroughness when dealing with our members over the phone. A flexible schedule that includes evening hours is necessary.

We believe everyone deserves the opportunity to live their healthiest life. Our mission is to help people live healthier lives and make the health system work better for everyone. We strive to create a culture that values inclusion, talented peers, comprehensive benefits, and career development opportunities.

Our goal is to advance health optimization on a global scale by providing equitable care that addresses health disparities and improves health outcomes.

We are an equal opportunities employer and welcome applications from diverse candidates.

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