
Healthcare Specialist
3 days ago
About Our Client
Our client is a modern benefits platform and full-service brokerage firm committed to helping companies create healthier workplaces. They combine expertise from benefits firms, technology startups, and insurance carriers to deliver a range of innovative solutions that empower employers and employees alike. Licensed in all 50 states, our client maintains strong relationships with major insurance carriers, providing comprehensive and reliable services. Their signature app serves as a go-to resource for employees, offering easy access to benefits information, tools, and resources to help members thrive.
About the Role
The Advocate will be responsible for resolving member inquiries related to claims, coverage, plan details, eligibility, and authorizations. This role involves utilizing internal systems, process flow documents, and a ticketing system to address member issues and proactively identify additional service needs. The ideal candidate will have excellent communication skills, strong organizational abilities, and a passion for providing exceptional customer service. Adaptability, teamwork, and the ability to learn quickly are essential for success in this role.
Key Responsibilities
- Provide high-quality customer support to ensure member satisfaction.
- Maintain a positive, empathetic, and professional attitude with customers at all times.
- Respond promptly and accurately to member inquiries via phone, service platform, and email.
- Resolve inquiries related to claims, appeals, providers, benefits, costs, and more.
- Document resolutions, member communications, and resolution times in the ticketing system.
- Collaborate with internal consultants and the service team to resolve issues.
- Reach out to carriers and providers for additional information as needed.
- Navigate internal systems to gather member, plan, and group details.
- Advise members on plan selection based on individual and financial needs.
- Schedule provider appointments on behalf of members.
Requirements
- 3+ years of experience in customer support, preferably in healthcare and claims.
- Proven ability to provide exceptional customer service with a focus on empathy and problem-solving.
- Strong written and verbal communication skills in English, including tone matching and empathy.
- Ability to multitask and prioritize effectively in a fast-paced environment.
- Ability to work independently and collaboratively within a team.
- Strong attention to detail with a focus on accuracy in all tasks.
- College degree preferred, or completion of at least 2 years of college education.
Work Conditions
- Salary: Competitive compensation based on experience.
- Equipment: All necessary equipment will be provided.
- Workstation: Your workstation should be set up in a safe and secure home environment with stable and reliable internet (minimum speed of 25 Mbps).
- Work Setup: Hybrid Setup (1x in a week)
- Working Hours: Monday to Friday, US Hours Required.
Benefits
- HMO Healthcare Coverage: Comprehensive coverage for you.
- Leave Days: 20 combined Sick Leave (SL) and Vacation Leave (VL).
- Government-Mandated Benefits: All mandatory benefits are included.
- Public Holidays: Paid time off for all Philippines Public Holidays.
What's Next?
Click "Apply" and attach your CV. We look forward to hearing from you
-
Healthcare Credentialing Specialist
1 day ago
Makati City, National Capital Region, Philippines Penbrothers Full time ₱350,000 - ₱700,000 per yearAbout PenbrothersPenbrothers is an HR & remote talent management partner and one of the fastest growing companies in the Philippines. We provide talented Filipinos with global opportunities in high-growth startups and dynamic companies, from the comfort of their own homes.About the ClientOur client is a fast-growing healthcare staffing agency dedicated to...
-
Healthcare Specialist
1 day ago
Makati City, National Capital Region, Philippines EMAPTA Full time ₱900,000 - ₱1,200,000 per yearThe Medical Records Specialist is responsible for analyzing claims eligible for arbitration. This individual should possess superior communication and computer skills including familiarity, Microsoft Outlook, Word and Excel. This individual will review, analyze and report reimbursement of integrity measures.Job Overview:Employment type: Full-timeSchedule:...
-
Makati City, National Capital Region, Philippines EC Healthcare Full time ₱900,000 - ₱1,200,000 per yearAbout EC HealthcareEC Healthcare is Hong Kong's largest non-hospital medical service provider, leveraging its core businesses of preventive and precision medicine, and committed to developing medical artificial intelligence by integrating its multi-disciplinary medical services. Aligning with our mission - to bring health, beauty and happiness to...
-
Healthcare Compliance
4 weeks ago
Makati City, National Capital Region, Philippines Pride Global Full timeHealthcare Compliance & Credentialing SpecialistAbout the CompanyPride Global is a minority-owned integrated human capital solutions & advisory firm with operating companies worldwide, including PrideOne, Russell Tobin, PrideBPO, PrideHealth, PrideNow, and Pride India. The company focuses on a diverse array of human resources solutions such as managed...
-
Sales Training Delivery Manager
6 days ago
Makati City, National Capital Region, Philippines Maxicare Healthcare Corporation Full time ₱400,000 - ₱1,200,000 per yearCompany DescriptionMaxicare Healthcare Corporation, established in 1987, is a pioneer in the health maintenance organization (HMO) industry in the Philippines. As the largest HMO provider in the country, Maxicare offers comprehensive healthcare programs through its extensive network of medical providers and strong customer support system. Currently serving...
-
Healthcare Specialist
1 week ago
Makati City, National Capital Region, Philippines Strategic Staffing Solutions Full time ₱900,000 - ₱1,200,000 per yearSTRATEGIC STAFFING SOLUTIONS (S3)Position: Healthcare Insurance AnalystWork Set-Up: OnsiteOffice Location:Century Tower, Makati CitySchedule:Night Shift (EST)JOB RESPONSIBILITIESConduct comprehensive audits on group members to evaluate their health insurance coverage, encompassing medical, dental, vision, and hearing benefits.Integrate modified membership...
-
Application Specialist
3 days ago
Quezon City, National Capital Region, Philippines VITALINE HEALTHCARE INC. Full time ₱1,200,000 - ₱2,400,000 per yearAbout the role Vitaline Healthcare seeking a highly skilled Application Specialist to join our team in Quezon City, Metro Manila. In this full-time position, you will play a crucial role in supporting our clients in the healthcare industry with the effective utilization of our cutting-edge medical technology products and services.Key ResponsibilitiesConduct...
-
Healthcare Specialist
1 week ago
Caloocan City, National Capital Region, Philippines Sapient Global Services Full time ₱170,000 - ₱300,000 per yearEasy and Fast One-day Hiring Process Earn up to 25k monthly plus more benefits We are looking for a Healthcare Specialist Representative in our Metro Manila Sites This is for urgent hiring, don't miss this opportunity and Apply NowResponsibilities:Answer inquiries regarding medical services, insurance coverage, and billing via phone calls.Assist patients...
-
Marketing Specialist
1 day ago
Makati City, National Capital Region, Philippines EG HEALTHCARE INC Full time ₱240,000 - ₱300,000 per yearBachelor's degree in Marketing, Communications or any related course.Thorough knowledge of social media and web analytics.Better with minimum 2 years experience in aesthetics, medical or healthcare marketing.Preferably with experience as content creator.Job Type: Full-timePay: Php20, Php25,000.00 per monthBenefits:Company Christmas giftCompany eventsHealth...
-
Follow-up MD Assistant/Nurse
3 days ago
Makati City, National Capital Region, Philippines Halcyon Marine Healthcare Systems Inc. Full time ₱60,000 - ₱120,000 per yearJob description:Updates Pre-employment Medical (PEME) based on guidelines.Verifies patient's medical records and assists Follow-up MDs and patients.Assists in Check listing on Doctors' notes.Prepares referrals to specialists.Uploads results and encodes clearance in the patient PEME. Job Qualifications:Graduate of any medical and allied courses.Preferably...