Healthcare Support Specialist

2 days ago

Taguig, National Capital Region, Philippines beBeeCustomerService Full time ₱1,990,000 - ₱2,990,000
Healthcare Customer Service Representative

We are seeking a skilled Healthcare Customer Service Representative to join our team. As a key member of our clinical support team, you will play a critical role in customer satisfaction and make 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. Your skills and talents will make an impact as you work with hospitals, clinics, facilities, and the clinical team to manage requests for services from members and/or providers.

Primary 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
  • Comply with employment contract terms, company policies, and procedures

This is a high-volume, customer-service environment that requires efficiency, productivity, and thoroughness when dealing with members over the phone. You will need to be flexible and work evening hours.

Required Qualifications:

  • High School Diploma or Equivalent
  • 1+ years of customer service experience analyzing and solving customer problems
  • Ability to create, edit, save, and send documents using Microsoft Word and Excel
  • Ability to type and talk at the same time and navigate through multiple screens

Preferred Qualifications:

  • Experience working within the healthcare industry and with healthcare insurance
  • Experience working with Medicare and/or Medicaid Services
  • Experience working in a metric-driven work environment
  • Call center experience
  • Knowledge of ICD-9 and CPT codes
  • Clerical or administrative support background

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