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maxicare healthcare corporation

Contact Center Specialist

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Job Description

Job Title: Customer Care Specialist SME

Division: Operations

Department: Operations Fulfillment - Account Services

Reports to (Position of Immediate Superior): Manager/Assistant Manager/Supervisor, Account Services-Concierge

Primary Job Responsibility

Responsible for the planning, organizing and control of the overall operations of the Contact Centers

I. Job Description

  • Duties and Responsibilities done at PERIODIC or REGULAR Intervals
  • Issues Letter of Authority after assessment of coverage, professionally explains non-coverage rationale to members
  • Screens, assess and processes availment cases based on procedures and benefit applications guidelines.
  • Ensures all transactions in the system are documented and filed accordingly
  • Responds inquiries and complaints at first hand resolution (if possible) on customers feedback and issues raised
  • Escalates complex availment cases based on set escalation procedures.
  • Collaborates with team members to achieve the agreed Key Results Areas
  • Complies to pre-advised shift schedule and ensures to support Operations 24/7.
  • Secures overriding approval from the Customer Care Supervisor for LOAs beyond the Specialists authority limits include tagging of special approval
  • Ensures operating costs reduction by property implementing use of office supplies/facilities including power, internet and phones
  • Complies in delivering excellent customer service by providing resolution to their queries and issues.
  • Can attend to all types of Inquiries and request of the client
  • Can assign to different roles and task
  • Duties and Responsibilities done at IRREGULAR or INTERMITTENT Intervals
  • Reports any systems-related issues and Team concerns to expedite processing
  • STANDARD RESPONSIBILITIES

Strives to embody, commits to support and deliver the quality policy, objectives and initiatives of the organization;

Communicates, engages, directs and supports people to contribute to the QMS effectiveness;

Demonstrates commitment to customers by ensuring applicable statutory and regulatory requirements are determined, understood and consistently met;

Abides by the QMS policies and procedures for the effective management and control of its processes; and

Promotes and utilizes the Process Approach and Risk-based Thinking at work.

Performs other RELATED functions that may be assigned BY THE IMMEDIATE SUPERIOR

II. JOB SPECIFICATIONS

  • SKILLS
  • EDUCATIONAL REQUIREMENT

MINIMUM educational level and background required by this POSITION: College Graduate of 4, 5 year-course, preferably:

Medical Allied Courses

  • EXPERIENCE AND TRAINING

PERIOD OF TIME OR LENGTH of related experience the CANDIDATE must acquire before being assigned to and perform the functions of this job, SATISFACTORILY under NORMAL supervision: at least 6 months hospital experience is an advantage but may not be required

  • SKILLS REQUIREMENT TECHNICAL (For Tech and Business Support, Supervisory and Professional)

Skilled or specialized: proficiency is gained thru wide experience in a SPECIALIZED or TECHNICAL area

  • RESPONSIBILITY
  • ACCOUNTABILITY ASSETS, CASH, EQUIPMENT

Value or worth of company assets (cash, checks, financial instruments, investments, tools, materials, machinery, equipment, and supplies) this POSITION is accountable for: Small below P500, 000

SPECIFY ASSETS, CASH AND EQUIPMENT DIRECTLY ACCOUNTED FOR: Head Set

  • ACCOUNTABILITY RECORDS AND DOCUMENTS

Level of CONFIDENTIALITY AND IMPORTANCE of the information, records, reports, and documents prepared, maintained, has access to, and handled by this POSITION Routinely, Low - Contents are of general nature; knowledge by others is NOT INIMICAL; disclosure may not have apparent effect on the company

RECORDS AND DOCUMENTS DIRECTLY ACCOUNTED FOR: Shared Documents

  • NEED FOR SUPERVISION

EXTENT of work supervised or managed by the Immediate Superior, whether the job is limited or diversified;

quantify range of activities, VARIETY of tasks to be carried out, and the DIVERSITY of the problem to be solved

Follows established procedures generally; refer only unusual cases to superior

  • PEOPLE MANAGEMENT

Number of subordinates this POSITION DIRECTLY supervise: None

  • CONTACTS INTERNAL AND EXTERNAL

EXTENT the work requires in making personal contacts inside and outside of the organization, level of importance of contacts; FREQUENCY they are made; LEVEL OR DEGREE they involve exchanging information, dealing with people, exerting influence, persuading them to take action, etc. Broad, Significant

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Job ID: 145294013