Health Care Account-Call Center Agent
Synlink Recruitment Outsourcing Co. Inc.
Descrição do Trabalho
Benefícios
Recompensas e reconhecimento de funcionário
Incentivos
Benefícios gerenciados pelo Governo
Fundo Pag-Ibig, Saúde, SSS/GSIS
Saúde e Bem-Estar
HMO
- Member/Patient Interaction* Respond to inbound calls from members, patients, and healthcare providers regarding eligibility, benefits, claims status, and enrollment inquiries.* Clearly explain complex health plan terminology, including deductibles, co-pays, co-insurance, out-of-pocket maximums, and prior authorization requirements.
- Claims & Billing Support* Investigate and resolve claims disputes, billing discrepancies, and provider payment issues by liaising with internal departments.* Guide members through the process of selecting a primary care physician (PCP) or navigating the provider network.
- Data Confidentiality & Compliance* Strictly adhere to all HIPAA (Health Insurance
- Portability and Accountability Act) regulations and company data privacy policies when handling Protected Health Information (PHI).* Accurately and thoroughly document all inquiries, transactions, and resolutions in the CRM system, ensuring compliance records are maintained.
- Quality & Performance* Maintain high performance scores for Quality Assurance (QA) audits, specifically focusing on process accuracy and regulatory compliance.* Aim for a high First Call Resolution (FCR) rate while managing Average Handle Time (AHT) efficiently.
Scigee Bustillos
HR OfficerSynlink Recruitment Outsourcing Co. Inc.
Mais de dez respostas hoje
Local de trabalho
Market! Market!. McKinley Pkwy, Taguig, Metro Manila, Philippines
Postado em 11 November 2025
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Synlink Recruitment Outsourcing Co. Inc.
Desfinanciado / Anjo
<50 Funcionários
Firma de Recrutamento
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