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HDSI: Customer Service Representative (Healthcare/HMO Account)

at RelianceUnited in Mandaluyong, PH

Work Type: On Premise | Employment Type: Full Time

Experience Level: Mid Level | Posted Date: 2025-04-14

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Description

Job Objective/Job Purpose:
The Customer Service Representative will act as a liaison, provide product/services information, coordinate with providers and facilities for member requests, answer questions, and resolve any emerging problems that our customer accounts might face with accuracy and efficiency.

This role will be hired under Health Delivery System, Inc. - a RelianceUnited company.

Duties and Responsibilities:

• Accept inbound calls from Flexicare members and accredited providers requesting for Letter of Authorizations. Address member concerns related to their health benefit program.
• Ensure that the LOA request is issued within the members’ benefits based on their respective benefit matrices, remaining limit, and eligibility.
• Conduct outbound calls as needed to assist with claim information or identify missing information.
• Document all encounters in clear and concise logs.
• Consistently meet individual performance standards/metrics.
• Assist in other related tasks that may be assigned.

Background and Qualifications:

• Bachelor’s Degree in medical field or any related degree.
• Having 2 years of solid working experience in TPA, HMO, insurance or insurance broker companies or BPO.
• Familiar with health insurance / HMO policies and coverages, preferred.
• Ability to work on shifting schedules and extend beyond company operating hours when needed.
• Amenable to work onsite as advised.
• Strong attention to detail.
• Strong communication (written and oral) and interpersonal skills.
• Organized, has strong attention to details, and can work with minimal supervision
• Proficiency in MS Office (Excel, Word, and PowerPoint) and/or G-Suite Tools.

Work Set-Up:
Location: Greenfield District, Mandaluyong City
Work Schedule: 8:00 AM to 5:00 PM (subject to change with management notice)

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Visit the RelianceUnited Website here:
https://www.relianceunited.com/
What it's like to Work at RelianceUnited:https://www.relianceunited.com/careers