We are looking for a
Healthcare Customer Service Representative to provide professional support to healthcare members through inbound calls. The role involves assisting members with concerns related to
benefits and eligibility, claims, and prior authorization (pre-auth) while ensuring accurate and efficient service.
The ideal candidate has experience handling international healthcare accounts, strong communication skills, and the ability to effectively understand and resolve member concerns.
Key Responsibilities
- Handle inbound calls from healthcare members and provide accurate assistance.
- Assist members with benefits and eligibility inquiries.
- Address claims-related concerns and provide appropriate information.
- Assist with prior authorization (pre-auth) inquiries and processes.
- Clearly explain healthcare-related information and procedures.
- Verify and document member information and call details accurately.
- Use active listening, analytical thinking, and problem-solving skills to resolve concerns.
- Escalate complex issues to the appropriate team when necessary.
- Maintain confidentiality when handling member information.
- Meet established customer service, quality, productivity, and attendance standards.
Qualifications
- College Graduate or Associate Graduate, any course.
- BS Nursing graduates are excluded from this position.
- At least 2 years of call center experience handling international accounts.
- Experience catering to healthcare members, particularly with:
- Prior Authorization / Pre-Auth
- Benefits and Eligibility
- Claims
- Strong English communication skills.
- Excellent listening and comprehension skills.
- Strong analytical and problem-solving abilities.
- Good interpersonal and customer service skills.
- Comfortable handling healthcare-related concerns through voice interactions.
- Willing to work under a hybrid setup and follow the required work schedule.
