Customer Service Representative – Healthcare – Manila

Are you passionate about delivering exceptional customer service and positively impacting people’s lives? Are you looking for a rewarding Customer Service Representative for a healthcare opening in Manila? Do you want to join a career-defining role in a global customer experience transformation company? Join Fusion CX as a Customer Service Representative in Fusion CX Manila for our healthcare process! As an employee of Fusion CX, you will be part of a team that values diversity and inclusion while working globally to provide outstanding customer experiences.

As a Customer Service Representative in healthcare, you will be the frontline advocate for our members, ensuring they receive accurate information and support regarding their benefits and plan options. Your expertise and dedication will help us uphold our service principles and enhance member satisfaction through effective communication and problem-solving.

Job Description:

Key Responsibilities of the Customer Service Representative  in  Healthcare

• Provide high-quality customer service by applying the client’s service principles.
• Educate members, families, providers, and caregivers on benefits and plan options through in-person, email, and telephone interactions.
• Accurately explain benefits and plan options, ensuring clarity and understanding.
• Follow up with members to clarify issues, determine causes, and identify and explain the solution.
• Escalate complex issues to management or other departments as needed.
• Meet and exceed departmental standards for quality, productivity, adherence to schedules and attendance, and more.
• Responds appropriately and promptly to member/internal staff/providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims, and all other issues following departmental policies and procedures and job aids.
• Takes ownership of the issue, focusing on providing solutions and options for members, as necessary through resolution of member
• Resolve issues, complaints, and questions efficiently and accurately to increase member satisfaction. Coordinate with providers and other departments as required.
• Participate in member calling projects to support overall membership retention goals of clients as a Customer Service Representative – Healthcare process.
• Follow policies, procedures, and job aids to maintain efficient and operations and compliance.
• Suggest improvements and efficient strategies to management; identify and report problems with workflows by following proper departmental procedures.
• Actively participates in departmental staff meetings and training sessions.
• Follows all appropriate Federal and State regulatory requirements and guidelines applicable to the client’s Group operations, as documented in company policies and procedures and compliant with HIPAA regulations.
• Document transactions by completing applicable member forms and summarizing actions in the computer system, adhering to departmental standards and regulatory requirements.
• Respond to routine member questions and concerns on specific medical group call queues as part of skill development.

Job Requirements

Essential qualities and skills of a Customer Service Representative – Healthcare to thrive in their role in Manila.

• Education: High School Graduate or equivalent degree.
• Experience/Skills:
  • 1-2 years of call center or related customer service experience required.
  • 1-2 years of experience with Medicare benefits, including Medicare Advantage Plans preferred.
  • Experience in the healthcare, insurance, or pharmacy industries is highly desirable.
  • Ability to maintain a calm demeanor in high-pressure situations.
  • Proficiency in data entry and general computer skills (e.g., word processing, email).
  • Effective oral and written communication skills with a professional and pleasant telephone manner.
  • Ability to handle a high volume of calls while providing excellent customer service.
  • Demonstrated efficiency in a high-call-volume environment.
  • Fluency in English is required; additional languages are a plus.

Why Join Fusion CX?

At Fusion CX, you will be crucial in enhancing the quality of Customer Service Representatives – Healthcare and member satisfaction. If you are seeking career-defining customer service or call center job openings in Manila, this is an opportunity you should not miss – join an inclusive and diverse team that values each individual’s contributions while working with a global customer experience company that offers dynamic growth opportunities. Enjoy a collaborative environment focused on continuous improvement and personal development, and benefit from a competitive salary, health benefits, and other perks that support your well-being. So, apply today if you’re ready to make a difference and thrive in a rewarding role as a Customer Service Representative in healthcare. Apply now to join Fusion CX as a Customer Service Representative for our healthcare process in Manila!