Customer Care Specialist

1 week ago

Cebu City, Central Visayas, Philippines beBeeAdvocate Full time ₱300,000 - ₱401,000
Customer Care Advocate

Transforming customer service into a personalized experience is our goal. As a key member of our team, you will play a vital role in delivering exceptional service to our customers.

You will assist individuals with a wide range of critical services, including updating account information, providing plan details, and resolving issues with plan utilization. We are looking for someone with a strong desire to help people, excellent communication skills, attention to detail, and organizational abilities.

Key Responsibilities:
  • Update account information such as billing options and changes of address or phone numbers.
  • Research premium billing discrepancies and prescription claims processed.
  • Educate beneficiaries on how the plan works, including benefits, cost sharing, and levels of coverage.
  • Submit mail requests for beneficiaries such as ID cards and formularies.
  • Look up medicines on the formulary to verify if they are covered, the tier and copay level, and if a drug is not covered, provide an explanation as to why.
  • Displays positive demeanor, technical accuracy, and conformity to company policies.
  • Understands CMS Guidance and ensures applicable Exhibits are being mailed per CMS Guidance.
  • Ensure HIPAA regulations are maintained within the immediate environment.
  • Responsible for concise and detailed notations as it pertains to member records.
  • Handles outbound calls for purposes of validating information.
  • Handles inbound calls by assisting members with a high level of accuracy and efficiency.
  • Escalates any member issues to management as necessary.
  • Responsible for maintaining a high level of call quality as set by client standards, which includes a 95% quality score, and answering 80-85% of calls within 30 seconds or less.
  • Communicate with coworkers, management, staff, customers, and others in a courteous and professional manner.
  • Conform with and abide by all regulations, policies, work procedures and instructions.
  • Respond promptly when returning telephone calls and replying to correspondence and faxes.
  • Act, dress, and behave in a professional manner to reflect a positive image of the company.
Required Skills and Qualifications:
  • Associate Degree preferably in Healthcare.
  • Minimum 3 years working in a fast-paced high-volume call center environment, retail customer service, preferably in healthcare or hospitality.
  • Ability to multi-task effectively with strong attention to detail when documenting customers' reasons for calling.
  • Excellent written communication skills.
  • Excellent problem-solving abilities - Must love customer service with excellent listening skills, demonstrate empathy and the ability to educate customers.
  • Ability to de-escalate matters in a calm and professional manner.
  • Comfortable with technology and navigating numerous systems simultaneously.
  • Unwavering dedication to serving a customer that has complex needs.
  • Requires strong technical skills with Microsoft Office (Excel, Word, and Outlook).
  • Must have an energetic phone presence - professional etiquette over the phone, through written and face-to-face communication.
  • Self-motivated, confident, reliable, and commitment to customer satisfaction.
  • Adherence to following internal policy.
  • Ability to interact professionally and maintain effective working relationships with superiors, coworkers, customers, and others.
  • Ability to break down complicated information into simple messages for the caller.

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