Clinical Support Representative

4 days ago

Iloilo City, Western Visayas, Philippines Carelon Global Solutions Full time ₱150,000 - ₱250,000 per year

Responsible for successfully completing the required basic training. Able to perform basic job functions with help from co-workers, specialists and managers on non-basic issues. Must pass the appropriate pre-employment test battery.

Primary duties may include, but are not limited to:

  • Responds to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
  • Analyzes problems and provides information/solutions. Operates a PC/image station to obtain and extract information; documents information, activities and changes in the database.
  • Thoroughly documents inquiry outcomes for accurate tracking and analysis.
  • Develops and maintains positive customer relations and coordinates with various functions within the company to ensure customer requests and questions are handled appropriately and in a timely manner.
  • Researches and analyzes data to address operational challenges and customer service issues. Provides external and internal customers with requested information.
  • Under immediate supervision, receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.
  • Uses computerized systems for tracking, information gathering and troubleshooting. Requires limited knowledge of company services, products, insurance benefits, provider contracts and claims.
  • Seeks, understands and responds to the needs and expectations of internal and external customers. Required to meet department goals.
  • Requires a HS diploma or equivalent; up to 1 year of previous experience in an automated customer service environment; or any combination of education and experience, which would provide an equivalent background.
  • For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.

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