Job Description
Full details about the role and requirements
Yukerja Summary
The HEALTHCARE SPECIALIST (CSR) | NO EXP | EASY ACCOUNT | 19k role at Metacom Careers is curated from Bossjob (category Kesehatan). Note the work location (Cebu, Central Visayas, Philippines) before applying. Yukerja.com is not the employer — applications are handled on the official source site.
The Healthcare Specialist (CSR) is responsible for delivering exceptional customer service by assisting patients, healthcare providers, and health plan members with inquiries related to benefits, eligibility, claims, billing, authorizations, and other healthcare services. The role requires strong communication skills, attention to detail, and the ability to maintain confidentiality while ensuring compliance with healthcare regulations.
Key Responsibilities:
- Respond to inbound and outbound calls, emails, or chat inquiries from patients, providers, and members.
- Explain healthcare benefits, eligibility, coverage, and policy information.
- Assist with claims status, billing concerns, prior authorizations, and referrals.
- Accurately document customer interactions in the company's system.
- Resolve customer concerns promptly or escalate complex issues to the appropriate department.
- Verify patient or member information while maintaining confidentiality and compliance with privacy regulations.
- Meet quality assurance, productivity, and customer satisfaction goals.
- Stay updated on healthcare policies, procedures, and regulatory requirements.
- Collaborate with internal teams to ensure timely resolution of customer concerns.
Qualifications:
- High school diploma or equivalent; associate's or bachelor's degree is a plus.
- Excellent verbal and written communication skills.
- Strong problem-solving and active listening abilities.
- Proficiency in Microsoft Office and customer relationship management (CRM) or healthcare systems.
- Ability to multitask and work in a fast-paced environment.
- Knowledge of medical terminology, health insurance, or claims processing is an advantage.
Preferred Skills:
- Strong interpersonal and customer service skills.
- Attention to detail and accuracy.
- Ability to handle sensitive information with professionalism.
- Time management and organizational skills.
- Adaptability and willingness to learn new healthcare processes.