HealthCare Associate

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.

The incumbent is responsible for handling patient inquiries, resolving account issues, coordinating with relevant parties, and ensuring exceptional customer service while maintaining accurate documentation. This role also involves providing feedback for process improvements and staying current with industry standards.

Job title:

HealthCare Associate

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.

Location:

Quezon City, Bridgetowne GigaPhilippines