Customer Service Representative - Cebu

We are looking for a Healthcare Customer Service Representative / Medical Associate who will provide professional and compassionate support to patients, members, healthcare providers, and other stakeholders. The role involves handling healthcare-related inquiries, assisting with account or insurance concerns, providing accurate information, and ensuring a positive customer experience.

The ideal candidate has strong communication skills, attention to detail, and a basic understanding of healthcare processes, medical terminology, or health insurance.

Key Responsibilities

• Handle inbound and/or outbound calls, emails, and chat inquiries from patients, members, healthcare providers, or clients.
• Assist customers with healthcare-related inquiries, account concerns, benefits, claims, eligibility, billing, or medical services.
• Provide accurate and timely information while following established healthcare policies and procedures.
• Verify and update patient/member information in accordance with company processes.
• Explain healthcare benefits, coverage, eligibility, claims status, and other account-related information when applicable.
• Coordinate with internal teams, healthcare providers, or other departments to resolve customer concerns.
• Document all customer interactions, requests, and resolutions accurately in the appropriate systems.
• Escalate complex or sensitive concerns to the appropriate team or department.
• Maintain confidentiality of patient and customer information in accordance with company policies and applicable privacy requirements.
• Meet established performance, quality, productivity, attendance, and customer satisfaction targets.
• Follow standard operating procedures, compliance requirements, and quality guidelines.
• Perform other healthcare customer service-related tasks as assigned.

Qualifications

• Open to fresh graduates or with at least 1 year of experience in Customer Service, Healthcare BPO, Medical BPO, Insurance, Claims, or a related field preferred.
• Healthcare, medical insurance, claims, or provider services experience is an advantage.
• Basic knowledge of medical terminology, healthcare processes, insurance, claims, or benefits is preferred.
• Excellent verbal and written communication skills.
• Strong active listening and customer service skills.
• Good problem-solving and critical-thinking abilities.
• Detail-oriented with strong documentation and organizational skills.
• Comfortable using multiple computer systems and applications.
• Willing to work shifting schedules, weekends, holidays, and night shifts as required.
• Willing to work onsite based on business requirements.
• High school diploma or equivalent; college-level education or a healthcare-related background is an advantage.

Preferred Skills

• Healthcare customer service experience
• Medical terminology
• Health insurance / claims knowledge
• Benefits and eligibility verification
• Provider or member services
• Strong communication and interpersonal skills
• Data entry and documentation
• Problem-solving and multitasking
• Ability to handle sensitive customer concerns professionally