
Helpdesk Specialist
1 day ago
Position Accountability Statement: The Helpdesk Specialist is accountable for the accurate implementation of member's healthcare benefit policies at the assigned helpdesk oce focusing on utilization management, the delivery of superior customer service at all times, and supporting steerage and primary care network (PCN) initiatives to enhance healthcare eciency and member experience.
Broad Responsibility Highlights: The following broad responsibility statements are representative of the basic expectations about the role or function. Depending on business needs and exigencies, these responsibility statements may be modified. Critical to any leadership function is the need to demonstrate flexibility and agility in adapting to the changing requirements of the business.
Review and process Letter of Authorization (LOA) in line with established procedures, ensuring accuracy and completeness. Provide clear explanations of coverage and non-coverage details. Verify transaction data, ensuring compliance with internal policies. Address customer and partner providers' inquiries promptly, oering accurate information.
Address escalations and resolve concerns related to outpatient or inpatient services and collaborate with internal teams if necessary to resolve issues and maintain high customer satisfaction.
Oers and steer members to any of Maxicare Primary Care Networks Maxicare services. Provide any recommended packages while promoting Maxicare's exclusive benefits, helping members understand the available services
Participate in business continuity planning (BCP) events and assist with various campaigns or tasks during manpower shortages or when service levels are low, ensuring smooth operations and responsiveness to immediate demands.
Professional Qualification:
● A Bachelor's degree in a Healthcare or Medical-related field is preferred. Alternatively, candidates with at least 3 years of college education and experience in the medical field, or equivalent work experience in Healthcare, Customer Service industry or Business Process Outsourcing (BPO) with strong client-facing and 2 years experience, may be considered.
● Excellent verbal and written communication skills.
● Proficient in data entry and transaction processing with attention to detail.
● Proficient in using Google Applications (Gmail, GSheets, GForm, GDocs & etc.).
Hospital Assigned Location (Vacant):
Makati Medical Center
St. Lukes Medical Center
Cardinal Santos Medical Center
Cebu based Hospital
The Medical City Ortigas
Working Set Up: ONSITE (Hospital based)
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