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