Patient Engagement Specialist

3 days ago

Makati City, National Capital Region, Philippines Booth and Partners Pte Ltd Full time ₱1,200,000 - ₱2,400,000 per year
Job Description
OpenLoop is looking for a Patient Engagement Specialist to join our team. This role will be a member of
the Revenue Cycle Management Team, collaborating closely with the Eligibility and Benefits Head.
Job Summary:
We are seeking a detail-oriented and knowledgeable Eligibility and Benefits Specialist to attend and
oversee the eligibility determination process for patients on multiple client programs. The specialist will
verify eligibility, assist on referral submission, and supply PHI in our billing platform. This role requires a
strong understanding of benefits programs and a commitment to delivering high-quality customer service.
Key Responsibilities:
● Review patient benefits through online portals and can outline required information if benefits are
obtained via call.
● Process and verify eligibility requirements based on program guidelines.
● Identify correct payer for Medicare and Medicaid Plans.
● Understands copay, coinsurance and deductible
● Handles inquiries and resolve issues regarding benefit eligibility
● Communicate with patients and provide explanation on the results of eligibility check and
potential cost.
● Ensure to update all RCM tools that require patient information.
● Coordinate with CMAs for any manual checks
● Can do outbound calls and emails to patients using problem solving and resolution skills
● May require referral submission.

RequirementsSkills and Qualifications:
Required:
● Strong understanding of benefits programs, eligibility criteria, and relevant regulations.
● Excellent attention to detail and organizational skills.
● Strong written and verbal communication skills.
● Proficiency in Microsoft Office Suite (Excel, Word, etc.).
● Customer service-oriented, with the ability to handle sensitive situations tactfully.
Preferred
● Prior experience in benefits administration, eligibility determination (copay, coinsurance, and
deductible), or healthcare benefits.
● Knowledge of regulatory frameworks like HIPAA (Health Insurance Portability and Accountability
Act), ACA (Affordable Care Act), or other benefits-related regulations.
● Understanding with Referral Submission.
● Experience with benefits software, CRMs and RCM Web tools (Zoho, RXNT)
● Experience with communication platform (Slack, Google Mail, Amazon Connect)
● Ability to work in a fast-paced environment with minimal supervision.

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