Customer Service Representative
Experience: Job Code: REQ-022115
Sagility
Quezon City
job Details
Job title
Customer Service Representative
About Sagility
Sagility combines industry-leading technology and transformation-driven BPM services with decades of healthcare domain expertise to help clients draw closer to their members. The company optimizes the entire member/patient experience through service offerings for clinical, case management, member engagement, provider solutions, payment integrity, claims cost containment, and analytics. Sagility has more than 25,000 employees across 5 countries.
Job title:
Job Description:
Education:
Graduate of a Bachelor's Degree without experience
Graduate of an Associate Degree (2-year vocational course) with 6 months customer service experience
College Undergraduate / (completed 2 years) with 6 months customer service experience
Experience:
Must have successful completion of English language proficiency training and have current and valid certification documentation.
Mandatory Skills:
With Moderate Competency Level in ff.:
Customer Service Orientation
Computer Literacy
Job Knowledge
Sense of Urgency
Passion for Excellence
Work Organization
Product Knowledge
Typing/Computer Skills
Problem Solving
Strong commitment to customer satisfaction and an ability to make quick and accurate decisions
Experience in qualitative analysis, root cause analysis, quality assurance practices, and problem-solving skills
Positive customer-based attitude and solution-oriented outlook
Ability to work independently with minimal supervision
Proficient use of Microsoft Office applications (Word, Excel, Outlook) and internet resources
With Excellent Competency Level in ff.:
Communication Skill (Oral)
Communication Skill (Written)
Relationship building skills and aptitude for working collaboratively with cross-functional groups
Attention to detail
Roles & responsibilities:
Handle inbound/outbound patient calls for support.
Investigate and conduct root cause analysis for inquiries received from patients and patient representatives
Responsible for accurately documenting steps taken and next steps needed to provide resolution
Coordinate with facilities, payors and collections agency related to a patient account
Review and resolve patient concerns, which include: demographic updates, insurance updates, resubmitting claims, payment processing / assistance, and collection cancellation notices
Review patient accounts, claim information and Explanation of Benefits to enable quick resolution of patient issues
Draft communications to patients, patient representatives, payors, and vendors as needed
Assist in responding to legal and financial assistance requests
Maintain various email accounts to ensure patient concerns are properly addressed in a timely manner
Evaluate customer service processes and provide feedback on improvement plan
Report on status of patient concerns, trends, and resolutions to the management team
Understand the account's Business Strategy and managed care direction
Utilize and be familiar with current system functions, applications and enhancements
Maintains resource materials such as updated disks, paper reference
Additional responsibilities include development and training of self and co-workers
Suggest and shares ideas for system improvement
Experiments with and accepts new ideas in a positive and timely manner
The Healthcare Associate must achieve and maintain the account's Key Performance Measures
Provide exceptional customer service to callers over the phone and/or through correspondence
Maintain a high level of professionalism towards peers and customers at all times
Abide by and be familiar with all the policies and procedures set forth by the client, the company and the program
Adhere to schedule and changes as advised by the immediate supervisor
Perform tasks in an efficient and effective manner with regard to the delivery of service requirements required by the client, project or company
The above statements are intended to indicate the general nature and level of work being performed by employees within this classification. They are not intended to be an exhaustive list of all responsibilities, duties and skills required of employees assigned to this job. Employees in this job may perform other duties as assigned.
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