We are seeking dedicated Call Center Associates to support our Medicare, healthcare, and dental provider accounts in a BPO setting. The role involves handling inbound and outbound calls from members, providers, and other stakeholders to address inquiries related to benefits, claims, eligibility, billing, authorizations, and enrollment. Associates must provide accurate information, ensure timely resolution of issues, and maintain compliance with HIPAA and CMS guidelines.

Customer & Provider Support

• Answer inbound calls from Medicare members, healthcare patients, and dental providers.
• Provide information on benefits, eligibility, coverage, and enrollment status.
• Assist providers with claim submissions, payment status, and billing inquiries.
• Handle escalations with empathy, professionalism, and accuracy.

Claims & Billing

• Process and verify healthcare and dental claims.
• Support prior authorizations, pre-certifications, and referrals.
• Investigate denied or delayed claims and provide resolution.
• Educate providers and members on claims procedures and billing guidelines.

Enrollment & Plan Support

• Guide members through Medicare and healthcare plan enrollment, changes, or cancellations.
• Verify patient and provider information in CRM systems.
• Explain dental and medical coverage options, including plan benefits and limitations.

Compliance & Documentation

• Adhere to HIPAA, CMS, and insurance compliance regulations.
• Accurately log all interactions in the call management system.
• Maintain service quality and meet performance metrics (AHT, FCR, CSAT, etc.).

Collaboration & Reporting

• Work with internal departments (claims, billing, provider relations) to resolve complex issues.
• Escalate unresolved cases to higher-level support or supervisors.
• Generate call logs and daily/weekly reports as required.

+OPEN FOR FRESH GRADUATES

+College graduate with or without bpo experience

+No Pending Application To SAGILITY / HGS

( for Entry Level ) Newbies Are welcome Call Center Jobs

START: September Class

Salary Range up to PHP 18,000- 20,000

Excluding Benefits

+ 20% Night Differentials 

+ HMO Day 1 For employee 

+ 13th and 14th Month Pay 

Salary Increase 

Retirement Plan 

90% Passing Rate

Paid Onboarding

Paid Training

VIRTUAL PROCESS ( VIA MSTEAMS ) FINAL INTERVIEW ONLY!

Can Start ASAP

BRIDGETOWNE Quezon City