Healthcare Representative

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Early Applicant

Job Description

Key Responsibilities

Respond to inbound inquiries regarding healthcare benefits, eligibility, claims status, and account information.
Assist patients and members in understanding healthcare plans, coverage details, and policy guidelines.
Resolve billing concerns, payment issues, and account discrepancies.
Document all interactions, requests, and resolutions in the system accurately.
Coordinate with internal departments, insurance carriers, or healthcare providers to resolve complex concerns.
Follow HIPAA, privacy, and compliance regulations when handling sensitive health information.
Meet performance metrics including quality, productivity, and customer satisfaction targets.
Provide first-call resolution whenever possible.
Educate customers on available services, processes, and self-service options.

Qualifications

SHS Graduate or Bachelor's Degree Graduate (Must have a diploma and TOR).
Experience in healthcare customer service, BPO, or call center operations is preferred.
Knowledge of healthcare insurance processes, claims handling, or medical terminology is a plus.
Strong verbal and written communication skills.
Ability to handle difficult customers with professionalism and empathy.
Basic computer navigation and data entry skills.

Skills And Competencies