Job Description
serves as the primary point of contact for health plan members, healthcare providers, and clients. This role is responsible for delivering exceptional customer service by assisting with inquiries related to health insurance benefits, eligibility, claims, billing, and other healthcare services. The ideal candidate demonstrates strong communication skills, empathy, problem-solving abilities, and a commitment to providing accurate and timely support.
Responsibilities
- Respond to inbound customer inquiries via phone, email, or chat in a professional and courteous manner.
- Assist members and healthcare providers with questions regarding health insurance benefits, coverage, eligibility, claims status, billing, and plan information.
- Verify member information and update customer records accurately in company systems.
- Educate customers on healthcare plans, policies, and available services using clear and easy-to-understand language.
- Resolve customer concerns by researching issues, identifying appropriate solutions, and ensuring timely follow-up.
- Escalate complex cases to the appropriate department when necessary.
- Document all customer interactions accurately and maintain complete records.
- Ensure compliance with HIPAA, company policies, and applicable healthcare regulations while protecting confidential information.
- Meet established performance metrics, including quality, productivity, attendance, customer satisfaction, and compliance standards.
- Stay informed about company products, healthcare policies, and process updates through ongoing training.
Qualification
College Graduate with or without experience
Completed 2 years in College with 6months work experience
Above Average English communication skills
Good interpersonal skills
Analytical and problem solving skills
Good comprehension skills
Basic knowledge with MS Office
Willing to work on weekends and holidays
Benefits
- 20% Night differential
- HMO coverage for employee upon Day 1 and HMO dependent upon certification
- Life and Accident Insurance
- Annual increase based on performance
- 13 and 14th month Pay
