Health Care Account-Call Center Agent
Synlink Recruitment Outsourcing Co. Inc.
Job Description
Benefits
Employee Recognition and Rewards
Incentives
Government Mandated Benefits
Pag-Ibig Fund, Philhealth, SSS/GSIS
Insurance Health & Wellness
HMO
- Member/Patient Interaction* Respond to inbound calls from members, patients, and healthcare providers regarding eligibility, benefits, claims status, and enrollment inquiries.* Clearly explain complex health plan terminology, including deductibles, co-pays, co-insurance, out-of-pocket maximums, and prior authorization requirements.
- Claims & Billing Support* Investigate and resolve claims disputes, billing discrepancies, and provider payment issues by liaising with internal departments.* Guide members through the process of selecting a primary care physician (PCP) or navigating the provider network.
- Data Confidentiality & Compliance* Strictly adhere to all HIPAA (Health Insurance
- Portability and Accountability Act) regulations and company data privacy policies when handling Protected Health Information (PHI).* Accurately and thoroughly document all inquiries, transactions, and resolutions in the CRM system, ensuring compliance records are maintained.
- Quality & Performance* Maintain high performance scores for Quality Assurance (QA) audits, specifically focusing on process accuracy and regulatory compliance.* Aim for a high First Call Resolution (FCR) rate while managing Average Handle Time (AHT) efficiently.
Scigee Bustillos
HR OfficerSynlink Recruitment Outsourcing Co. Inc.
Reply 0 Times Today
Working Location
Market! Market!. McKinley Pkwy, Taguig, Metro Manila, Philippines
Posted on 11 November 2025
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