Healthcare Customer Service Representative
3 weeks ago
We are excited to announce the recruitment of multiple client support roles at our Healix Health office. If you are seeking a fulfilling career in the healthcare sector and possess exceptional customer service abilities, you may be an ideal candidate for our Member Care Consultant position.
As a Member Care Consultant, your primary responsibilities will include coordinating member treatment plans, collaborating with the healthcare team, and ensuring that members receive the necessary medical information and access to services. This role emphasizes the importance of outstanding customer service skills, and no medical qualifications are required.
Key Responsibilities
- Handling inquiries from clients, providers, and members regarding initial and ongoing claims.
- Collecting medical evidence from providers to support claims decisions and treatment.
- Addressing questions related to clinical treatment or pre-authorization requests.
- Coordinating care with the appropriate medical teams and facilities.
- Monitoring ongoing treatment plans to ensure the relevance and appropriateness of delivered care.
- Negotiating provider fees within the established guidelines to support cost containment for clients.
- Accurately allocating all documents within the Case Management System.
- Assisting Case Managers with high-cost claims as needed.
Qualifications
We are looking for candidates who possess the following skills and attributes:
- A solid understanding of the private medical insurance sector and claims processing is advantageous.
- Proactive in staying informed about client requirements and capable of interpreting relevant policy documentation.
- Exceptional customer service standards and a customer-centric mindset.
- Strong decision-making skills and the ability to work independently.
- Excellent verbal and written communication skills with a diplomatic approach.
- High attention to detail and the ability to perform well under pressure.
- Effective problem-solving and analytical capabilities.
- Commercial awareness with the ability to consider the broader context in decision-making.
- Ability to communicate effectively with clinicians and assess information accurately.
- A keen awareness of new technologies and developments within the industry.
About Healix
Healix provides comprehensive healthcare benefits and assistance globally. Our mission is to support individuals in challenging situations, whether facing a medical emergency or navigating complex healthcare needs. Our team consists of skilled professionals dedicated to ensuring that clients receive the necessary support and care.
We pride ourselves on being adaptable and responsive to the unique needs of our clients, working closely with various organizations to tailor our services accordingly. Our culture emphasizes initiative and problem-solving, allowing our specialists to effectively address unexpected challenges.
At Healix, we value a diverse workforce and strive to create an inclusive environment where all employees can thrive. We offer a range of benefits and opportunities for professional development, fostering a supportive team atmosphere.
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