Associate BPM Lead (SME, Healthcare Helpdesk)

Role Description

As a Subject Matter Expert (SME) in Healthcare Helpdesk, you will serve as a key resource in delivering high-quality support and guidance on complex healthcare-related inquiries. Your deep understanding of insurance benefits, provider contracts, eligibility, and claims will enable you to resolve escalated issues, mentor team members, and contribute to process improvements. Success in this role requires advanced communication, analytical thinking, and problem-solving skills, along with a strong understanding of helpdesk systems and healthcare operations

Key Responsibilities:

• Serve as the primary escalation point for complex inquiries related to insurance benefits, claims processing, provider contracts, and member eligibility
• Handle escalated calls from customers, ensuring concerns are addressed with urgency, empathy, and professionalism
• Provide expert-level support via phone and written correspondence, ensuring accurate and comprehensive responses
• Analyze and resolve advanced customer issues with professionalism and efficiency, using data-driven insights
• Troubleshoot technical issues related to helpdesk platforms, CRM systems, and healthcare databases, escalating to IT teams when necessary
• Document customer interactions and resolutions thoroughly to support quality assurance and continuous improvement
• Collaborate with internal teams to streamline workflows and enhance service delivery
• Conduct root cause analysis on recurring issues and recommend actionable solutions
• Lead knowledge-sharing initiatives and provide training or coaching to helpdesk associates
• Ensure compliance with healthcare regulations and internal policies while adapting to evolving procedures and systems
• Maintain a customer-centric approach, fostering trust and satisfaction through proactive communication and follow-up
  
  

Qualifications:

Experience:

• Minimum of 2 years in a healthcare customer service or helpdesk environment, with demonstrated expertise in insurance and claims processes
  
  

Skills:

• Advanced oral, written, and interpersonal communication skills
• Strong analytical and problem-solving capabilities
• Proficiency in CRM systems, healthcare databases, and automated tools
• Ability to manage multiple priorities in a dynamic, fast-paced setting
• Leadership qualities with a focus on mentoring and team collaboration
• High attention to detail and commitment to accuracy
  
  

Others:

• Proven ability to handle complex functions independently and efficiently
• Demonstrated adaptability to diverse customer scenarios and evolving business needs
• Willingness to work night shifts and onsite in Taguig
  
  

Skills

Healthcare, Customer Service, Call Center, Communication, Leadership