Healthcare Operations Specialist

2 days ago

Taguig, National Capital Region, Philippines beBeeExpert Full time ₱900,000 - ₱1,200,000

Subject Matter Expert - Healthcare Operations

">

We are seeking a highly skilled Subject Matter Expert to join our team. As a key member of our healthcare operations team, you will be responsible for verifying the eligibility and coverage of patients' insurance plans.

This is a challenging role that requires strong analytical and problem-solving skills, as well as excellent communication and interpersonal skills. You will work closely with our VOB Representatives to ensure timely and accurate resolution of accounts, reviewing documents, initiating and following up authorizations, updating and correcting patients' insurance information.

Additionally, you will co-manage volume and ensure that turnaround time is achieved day in and day out. You will also be responsible for the performance and development of your team members.

Responsibilities:
  • Co-train and prepare VOB representatives to handle verification of benefits tasks and solving authorization and date-of-service issues by utilizing available tools and following eligibility methods of different insurances.
  • Prepare reports and analyze data to assist management in determining campaign goals, including daily task assignments, task rotation, SLA monitoring, and rush requests completion.
  • Assist in identifying operational issues, including escalation of critical items to supervisors/managers and onshore counterparts; determine trends and suggest possible improvements in process and system/tools.
  • Monitor and evaluate agent performance, specifically on efficiency and quality of output, providing learning or coaching opportunities.
  • Ability to adapt to and work with different tools and systems used to carry out duties and responsibilities; adapt to frequent changes in the work environment.
  • Promote company culture by ensuring agents understand and comply with program objectives, mission statements, performance standards, and policies; ensure team compliance to regulations, observe legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA).
  • Work with other SMEs and management team members to support agents and ensure client satisfaction.
  • Other subject matter experts' duties as assigned.
Required Skills and Qualifications:
  • College diploma or equivalent, but more education, especially in management or healthcare, is preferred.
  • Minimum of 2 years of experience in healthcare accounts (preferably with strong background for Verification of Benefits and Authorization process)
  • Customer service, or supervisory experience may be required.
  • Proficiency with technology, especially computers, software applications, and phone systems.
  • Exceptional verbal and written communication skills.
  • Strong understanding of company products, policies, and services.
  • Ability to coach, train, and motivate employees and evaluate their performance.
  • Excellent problem-solving, leadership, and customer service skills.
  • Analytical, efficient, and thorough.
  • Ability to remain calm and courteous under pressure and navigate tense situations, especially during busy hours.
Benefits:
  • Mid-senior level position with opportunities for growth and development.
  • Full-time employment with a competitive salary and benefits package.
  • Collaborative and dynamic work environment with a team-oriented culture.
Others:
  • Job function: Customer Service
  • Industries: Hospitals and Healthcare
  • Seniority level: Mid-Senior
  • Employment type: Full-time

  • Talent Identification Specialist

    16 hours ago

    Taguig, National Capital Region, Philippines Tenet Healthcare Full time

    Talent Identification Specialist role at Tenet HealthcareOverviewTalent Identification Specialist at Tenet Healthcare. Direct message the job poster from Tenet Healthcare.ResponsibilitiesProvide support and coordinate with US Partners in the recruitment process of the Company.Source candidates through a variety of search methods (social media, applicant...

  • Payroll Specialist

    16 hours ago

    Taguig, National Capital Region, Philippines Tenet Healthcare Full time

    OverviewOverviewPayroll Specialist - Can start ASAP role at Tenet Healthcare. Direct message the job poster from Tenet Healthcare.ResponsibilitiesManages payroll queries, requests and disputesMonitors and tracks progress and prepare dashboardProcesses last pay and prepare reports i.e. Leaves Reports, JV entries etc.Handles bank requirements from account...

  • Healthcare Recruitment Specialist

    6 hours ago

    Taguig, National Capital Region, Philippines beBeeHealthcare Full time $40,000 - $80,000

    Healthcare Recruitment SpecialistWe are seeking a results-driven professional to source, screen, and hire top healthcare professionals for our US-based clients. The ideal candidate will have a deep understanding of the US healthcare industry, strong interpersonal skills, and the ability to manage the full recruitment lifecycle.Key Responsibilities:Sourcing...

  • Healthcare Coding Specialist

    2 days ago

    Taguig, National Capital Region, Philippines beBeeCoding Full time ₱35,000 - ₱70,000

    The Healthcare Coding Specialist is responsible for reviewing, analyzing, and assigning accurate codes to medical records. This role ensures coding compliance with regulations, payer guidelines, and facility policies.Key Responsibilities:Review and analyze inpatient medical recordsAnalyze and assign ICD-10-CM/PCS diagnosis and procedure...

  • Healthcare Support Specialist

    5 days ago

    Taguig, National Capital Region, Philippines beBeeCustomerSupport Full time ₱3,000,000 - ₱4,300,000

    Healthcare Support SpecialistThis role supports healthcare providers with various issues related to benefits, billing, authorizations, and more.We are looking for compassionate individuals who can provide excellent customer service and navigate complex computer systems to resolve provider issues efficiently.The successful candidate will be responsible...

  • Medical Healthcare Specialist

    7 hours ago

    Taguig, National Capital Region, Philippines beBeePhysicianAssociate Full time ₱400,000 - ₱800,000

    Job SummaryAn entry-level Physician Associate position is available at our medical institution. As a key member of our healthcare team, you will provide high-quality patient care under the supervision of senior physicians or specialists.Duties and ResponsibilitiesPatient Care: Conduct thorough medical assessments, gather patient history, perform physical...

  • Accurate Healthcare Information Coordinator

    5 days ago

    Taguig, National Capital Region, Philippines beBeeClinical Full time ₱900,000 - ₱1,200,000

    Clinical Data Specialist RoleThe Clinical Data Specialist plays a vital part in ensuring the accuracy and completeness of critical healthcare data, contributing to the overall quality of patient care.

  • Healthcare Revenue Cycle Specialist

    6 hours ago

    Taguig, National Capital Region, Philippines beBeeRevenue Full time ₱250,000 - ₱450,000

    We are seeking a seasoned medical billing professional to play a key role in our U.S. healthcare team's revenue cycle management operations.This is an excellent opportunity for experienced medical billers with a strong background in claims submission, payment posting, and denial management to join a collaborative and high-performance environment.Key...

  • Data Analyst

    2 days ago

    Taguig, National Capital Region, Philippines Tenet Healthcare Full time

    OverviewData Analyst role at Tenet Healthcare. This position leads the implementation and operation of service performance reporting for Tenet GBC workstreams. The ideal candidate has a strong combination of management skills and execution ability to establish a structured measurement system within the supported workstream. The specialist will work closely...

  • Customer Service Operations Specialist

    4 days ago

    Taguig, National Capital Region, Philippines beBeeOperations Full time

    Job Title: Customer Service Operations SpecialistThis is an exciting opportunity to join our team as a Customer Service Operations Specialist. In this role, you will be responsible for managing inbound fax lines, sorting and processing documents efficiently and accurately.You will handle initial and ongoing communication with doctors and providers to pursue...