Customer Service Representative

We are looking for a Healthcare Customer Service Representative / Medical Associate who will provide professional and compassionate support to patients members healthcare providers and other stakeholders. The role involves handling healthcare-related inquiries assisting with account or insurance concerns providing accurate information and ensuring a positive customer experience.

The ideal candidate has strong communication skills attention to detail and a basic understanding of healthcare processes medical terminology or health insurance.

• Handle inbound and/or outbound calls emails and chat inquiries from patients members healthcare providers or clients.
• Assist customers with healthcare-related inquiries account concerns benefits claims eligibility billing or medical services.
• Provide accurate and timely information while following established healthcare policies and procedures.
• Verify and update patient/member information in accordance with company processes.
• Explain healthcare benefits coverage eligibility claims status and other account-related information when applicable.
• Coordinate with internal teams healthcare providers or other departments to resolve customer concerns.
• Document all customer interactions requests and resolutions accurately in the appropriate systems.
• Escalate complex or sensitive concerns to the appropriate team or department.
• Maintain confidentiality of patient and customer information in accordance with company policies and applicable privacy requirements.
• Meet established performance quality productivity attendance and customer satisfaction targets.
• Follow standard operating procedures compliance requirements and quality guidelines.
• Perform other healthcare customer service-related tasks as assigned.

• Open to fresh graduates or with at least 1 year of experience in Customer Service Healthcare BPO Medical BPO Insurance Claims or a related field preferred.
• Healthcare medical insurance claims or provider services experience is an advantage.
• Basic knowledge of medical terminology healthcare processes insurance claims or benefits is preferred.
• Excellent verbal and written communication skills.
• Strong active listening and customer service skills.
• Good problem-solving and critical-thinking abilities.
• Detail-oriented with strong documentation and organizational skills.
• Comfortable using multiple computer systems and applications.
• Willing to work shifting schedules weekends holidays and night shifts as required.
• Willing to work onsite based on business requirements.
• High school diploma or equivalent; college-level education or a healthcare-related background is an advantage.

• Healthcare customer service experience
• Medical terminology
• Health insurance / claims knowledge
• Benefits and eligibility verification
• Provider or member services
• Strong communication and interpersonal skills
• Data entry and documentation
• Problem-solving and multitasking
• Ability to handle sensitive customer concerns professionally