Membership Service Advocate
Helpware
Date: 23 hours ago
City: Cebu City
Contract type: Full time

About Us
Helpware is a technology-driven company with offices in the USA, Ukraine, Mexico, and the Philippines which provides Customer Experience & Operational Support for modern companies. Our team of professionals is driven by the purpose of providing best-in-class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.
Position Summary
As a Member Services Advocate, you will be a part of a team that transforms customer service into
Customer Care by delivering an amazing experience. You will assist beneficiaries with a wide range of
critical services, which include but not limited to updating account information, providing plan information,
resolving issues with utilization of the plan. Qualified candidates will have a strong desire to help people
with strong customer care skills, attention to detail, and highly organized.
Responsibilities
As our customers share concerns and provide us with valuable feedback, your ability to recognize and complete the steps necessary to meet their needs will leave a permanent, lasting impression of the passion you have for helping them be at their best. We make sure our customers are not alone when it comes to understanding their benefits and they will rely on you to advocate for them as you would your own family member. In addition to the keys to success identified above that you will bring with you to the team, you will need to demonstrate the following abilities:
Helpware is a technology-driven company with offices in the USA, Ukraine, Mexico, and the Philippines which provides Customer Experience & Operational Support for modern companies. Our team of professionals is driven by the purpose of providing best-in-class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.
Position Summary
As a Member Services Advocate, you will be a part of a team that transforms customer service into
Customer Care by delivering an amazing experience. You will assist beneficiaries with a wide range of
critical services, which include but not limited to updating account information, providing plan information,
resolving issues with utilization of the plan. Qualified candidates will have a strong desire to help people
with strong customer care skills, attention to detail, and highly organized.
Responsibilities
As our customers share concerns and provide us with valuable feedback, your ability to recognize and complete the steps necessary to meet their needs will leave a permanent, lasting impression of the passion you have for helping them be at their best. We make sure our customers are not alone when it comes to understanding their benefits and they will rely on you to advocate for them as you would your own family member. In addition to the keys to success identified above that you will bring with you to the team, you will need to demonstrate the following abilities:
- Update account information such as billing options and changes of address or phone numbers.
- Research premium billing discrepancies and prescription claims processed.
- Educate beneficiaries on how the plan works, including benefits, cost sharing, and levels of
- coverage.
- Submit mail requests for beneficiaries such as ID cards and formularies.
- Look up medicines on the formulary to verify if they are covered, the tier and copay level, and if
- a drug is not covered, provide an explanation as to why.
- Displays positive demeanor, technical accuracy, and conformity to company policies.
- Understands CMS Guidance and ensures applicable Exhibits are being mailed per CMS Guidance.
- Ensure HIPAA regulations are maintained within the immediate environment.
- Responsible for concise and detailed notations as it pertains to member records.
- Handles outbound calls for purposes of validating information.
- Handles inbound calls by assisting members with a high level of accuracy and efficiency.
- Escalates any member issues to management as necessary.
- Responsible for maintaining a high level of call quality as set by client standards, which includes
- a 95% quality score, and answering 80-85% of calls within 30 sec. or less
- Communicate with coworkers, management, staff, customers, and others in a courteous and
- professional manner.
- Conform with and abide by all regulations, policies, work procedures and instructions.
- Respond promptly when returning telephone calls and replying to correspondence and faxes.
- Act, dress, and behave in a professional manner to reflect a positive image of the company.
- Meet average QA score of 95%
- Comply with attendance guidelines of 98%
- Schedule adherence of 90% or higher
- Maintain AHT below certain standards
- Associate Degree preferably in Healthcare
- Minimum 3 years working in a fast paced high volume call center environment, retail customer
- service, preferably in healthcare or hospitality
- Ability to multi-task effectively with strong attention to detail when documenting customers
- reasons for calling
- Excellent written communication skills
- Excellent problem-solving abilities - Must love customer service with excellent listening skills,
- demonstrate empathy and the ability to educate customers
- Ability to de-escalate matters in a calm and professional manner
- Comfortable with technology and navigating numerous systems simultaneously
- Unwavering dedication to serving a customer that has complex needs
- Requires strong technical skills with Microsoft Office (Excel, word, and Outlook)
- Must have an energetic phone presence - professional etiquette over the phone, through written
- and face to face communication
- Self-motivated, confident, reliable and commitment to customer satisfaction
- Adherence to following internal policy
- Ability to interact professionally and maintain effective working relationships with superiors,
- coworkers, customers, and others
- Ability to break down complicated information into simple messages for the caller
How to apply
To apply for this job you need to authorize on our website. If you don't have an account yet, please register.
Post a resumeSimilar jobs
Engagement Project Manager II
RealPage, Inc.,
Cebu City
20 hours ago
SummaryProject Manager II is responsible for planning, executing and closing projects within specific constraints such as time, budget, scope and quality expectations to ensure that project goals are met successfully, and the project delivers the expected value within the constraints. This includes the agreed upon deployment schedule, as well as the status of the deliverables needed to deploy each product....

Supervisor, Controls & Compliance
Concentrix,
Cebu City
1 day ago
Job Title:Supervisor, Controls & ComplianceJob DescriptionLocation:PHL Cebu City - Cebu Exchange Tower, Salinas Drive, Cebu IT Park, LahugLanguage Requirements:Time Type:Full timeIf you are a California resident, by submitting your information, you acknowledge that you have read and have access to the Job Applicant Privacy Notice for California ResidentsR1430774

Senior IT Internal Auditor
QBE Insurance,
Cebu City
4 days ago
Primary DetailsTime Type: Full timeWorker Type: EmployeeThe role is expected to lead IT related internal audits end-to-end, ensuring that key deliverables and milestones are achieved. They are expected to perform risk assessment and controls testing and contribute towards the completion of the work programme and drafting of audit reports.Responsibilities:Lead audit engagements, developing timetables, engaging stakeholders, and coordinating the key deliverables.Ensure...
