Healthcare Account Specialist
Healthcare Account Specialist
metacom careers2-4 Years
- Posted 14 days ago
- Be among the first 10 applicants
Job Description
Job Responsibilities
- Handle inbound customer calls and provide professional assistance to members of an international healthcare account.
- Assist members with benefits and eligibility inquiries, including coverage, plan details, and member information.
- Process and provide support for prior authorization (pre-authorization) requests.
- Assist with claims-related concerns, including claim status, coverage, and general claims inquiries.
- Accurately document customer interactions and update member information in the appropriate systems.
- Resolve member concerns efficiently while maintaining a high standard of customer service.
- Coordinate with healthcare providers, insurance teams, and internal departments when necessary.
- Follow company policies, healthcare account procedures, and data privacy requirements.
- Meet established quality, productivity, and customer satisfaction standards.
- College graduate or Associate graduate, any course.
- BS Nursing graduates are excluded from this role.
- At least 2 years of call center/BPO experience handling international accounts.
- Experience handling healthcare members, particularly:
- Benefits & Eligibility
- Prior Authorization (Pre-Auth)
- Claims
- Member inquiries and concerns
- Strong communication and customer service skills.
- Comfortable working with multiple systems and handling sensitive member information.
- Willing to work on a hybrid setup.
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