Customer Service Representative

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Why Join ContactPoint360?

At ContactPoint360, we think differently. We believe in putting employees at the heart of everything we do, creating a culture where innovation and empathy are not just buzzwords, but a way of life. Here, you won't just be a coworker; you'll be part of a team that redefines both employee and customer experiences. Our coworkers are essential partners in delivering exceptional work and are also friends who support and uplift each other.

We are one of the fastest-growing BPOs in the world, and our secret is simple: it's our people.We invest in our people and develop them into future leaders. Did you know that 50% of ContactPoint360's leaders were promoted from within? Our CEO's journey, starting as a phone agent, reflects our commitment to genuine care for our people—it's in our DNA.

Join the #ChangeMakers movement at ContactPoint360, where your creativity and passion aren't just welcomed—they're essential.

Our Purpose:

It is to create the best human experience, ensuring the highest client satisfaction, and transforming clients' customers into loyal advocates for life.

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Job Summary Purpose:

We are seeking a Philippine Registered Nurse (RN) to join our dynamic BPO team under our insurance account. In this role, you will leverage your medical expertise to manage and analyze medical records and insurance claims, ensuring accuracy, compliance, and timely resolution for legal and insurance cases. This position offers a unique opportunity for nurses to apply their healthcare knowledge in a professional, fast-paced business environment while exploring a rewarding career path beyond traditional clinical practice.

Key Responsibilities:

• Claims Processing & Management

• Review and analyze medical records and related documents for insurance claims accuracy and compliance

• Process insurance claims in accordance with company policies and regulatory standards
• Collaborate with insurance adjusters, healthcare providers, and clients to clarify claim details and resolve discrepancies
• Ensure timely and accurate processing of claims to meet service level agreements (SLAs)

• Medical Record Analysis

• Examine medical documents to verify diagnoses, treatments, and procedures in relation to claims

• Identify any inconsistencies or potential fraud and escalate issues as necessary
• Provide detailed reports and summaries for legal and insurance case reviews

• Quality Assurance & Compliance

• Ensure adherence to industry regulations and internal quality standards

• Maintain confidentiality and integrity of all medical and insurance records
• Participate in audits and quality improvement initiatives

• Communication & Collaboration

• Coordinate with internal teams and external stakeholders to resolve claim-related inquiries

• Provide expert medical input to support decision-making processes
• Assist in training new team members and sharing best practices

Qualifications:

• Must be a PRC-licensed Registered Nurse (RN).
• Prior experience in clinical practice, medical records handling, or healthcare documentation is an advantage.
• BPO experience is a plus but not required.
• Strong attention to detail and ability to work with sensitive medical information.
• Excellent communication skills (both written and verbal).
• Ability to analyze medical records and extract relevant data.
• Knowledge of HIPAA, data privacy laws, or other healthcare compliance is an advantage.
• Ability to work in a fast-paced, team-oriented environment.

Company Information

What's in it for you?

• Great base salary
• HMO Medical Insurance
• Dental Coverage
• Paid Vacation and Sick leave
• 13th-Month Pay
• Career & Leadership Development Training Programs
• Corporate Employee Discounts on Partnered Stores

WE ARE AN EQUAL OPPORTUNITY EMPLOYER

We consider applicants for all positions without regard to race, color, religion, creed, gender, national origin, or disability, which can be reasonably accommodated without undue hardship, veteran status, or any other legally, protected classification.

Join our Amazing Team Today and Embrace Excellence Together