Synlink Recruitment Outsourcing Co. Inc. Health Care Account-Call Center Agent

Synlink Recruitment Outsourcing Co. Inc.

R$1.6-3K[月薪]

现场办公 - 達義無需經驗高中全職

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.