Healthcare Customer Service Representative – Payer Experience

4 days ago

Pasay, National Capital Region, Philippines Access Healthcare Services Manila, Inc. Full time ₱250,000 - ₱450,000 per year

Job Overview:

We are seeking a dedicated and experienced Healthcare Customer Service Representative (CSR) to join our team on a short-term contract. This role will primarily focus on an outbound program, engaging with clients and payers to provide efficient healthcare support services. This role involves conducting outbound calls to verify chronic conditions with members and payers. The ideal candidate will have strong payer call center experience and a solid healthcare background.

Key Responsibilities:

  • Accurately capture and update member information in the system.
  • Ensure compliance with company policies, HIPAA regulations, and quality standards.
  • Meet productivity and accuracy targets within specified timelines.

  • Collaborate with team members, trainers, and supervisors to ensure smooth process ramp-up.

  • Make outbound calls to patients, providers, and payers to address healthcare-related inquiries.

  • Manage and resolve issues related to claims, authorizations, billing, and patient account services.
  • Accurately document call interactions and update internal systems.
  • Provide excellent customer service while adhering to HIPAA and company compliance standards.
  • Collaborate with team members and supervisors to ensure targets and timelines are met.

Qualifications:

  • Proven experience as a Healthcare CSR (required).
  • Prior payer experience is a must.
  • Strong communication and interpersonal skills.

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