Deskripsi Pekerjaan
Are you a Medical Allied graduate with a passion for helping others and a background in the BPO industry? Optum is seeking a dedicated US Healthcare Customer Service Representative to join our high-performing team in Alabang. In this role, you will be the primary point of contact for our US-based members, providing critical support, answering inquiries, and navigating complex healthcare concerns with empathy and professionalism.
At Optum, we don't just answer calls; we provide solutions that help people live healthier lives. You will utilize your healthcare knowledge and customer service expertise to resolve issues, clarify benefits, and guide members through the US healthcare landscape. If you are looking for a career that combines your medical background with top-tier BPO training and international exposure, this is your opportunity to grow with a global leader in healthcare innovation.
Tanggung Jawab
- Respond to inbound customer service inquiries via phone, chat, or email, identifying the specific needs of US healthcare members.
- Analyze and explain complex health insurance benefits, claims, and provider networks to ensure member satisfaction.
- Document all customer interactions accurately within the CRM system, ensuring adherence to HIPAA and internal compliance standards.
- Resolve member issues by collaborating with cross-functional teams, including billing, claims, and clinical departments.
- Identify and escalate complex cases to appropriate departments while maintaining a high level of member advocacy.
- Maintain consistent quality scores and productivity metrics in a fast-paced, high-volume environment.
- Stay updated on changing healthcare policies, plan designs, and internal protocols to provide accurate information.
Kualifikasi
- Graduate of any Medical Allied course (e.g., Nursing, Pharmacy, Medical Technology, Physical Therapy, etc.).
- Minimum of 6 months to 1 year of proven BPO experience, preferably in a US Healthcare account.
- Strong command of the English language with excellent verbal and written communication skills.
- High level of empathy and emotional intelligence to handle sensitive healthcare-related member inquiries.
- Proficiency in basic computer applications and ability to navigate multiple systems simultaneously.
- Must be willing to work in Alabang, Metro Manila, on shifting schedules (including nights and holidays).
- Solid understanding of US healthcare terminology and standard insurance concepts.