1 8df4c0dd0b89

Customer Service Representative

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EXPECTED SALARY
Php 30,000.00/month
( $521 USD )
EDUCATIONAL ATTAINMENT
Bachelors degree
AVAILABILITY
10 hrs/wk
( $12.05 USD/hr )
EXPERIENCE OVERVIEW
4  years as Healthcare Customer Service Representative
BASIC INFORMATION
Age:
45
Gender:
Female
Location:
Mandaue City, Cebu
Tests Taken:
IQ
Score:  105

DISC
Dominance:23%
Influence:20%
Steadiness:36%
Compliance:22%

English
 C2(Advanced/Mastery)
Last Active:
September 29th, 2022 (4 days ago)
Member Since:
February 15th, 2022
SKILL SUMMARY

Healthcare Customer Service  Advocate 
Benefits and Eligibility Expert
Experienced in handling a VIP client
- Benefits and Eligibility : give accurate information to Providers about the plan benefits of Members which includes plan coverage including the procedures - making sure that the CPT and DX codes were correct and are covered , DME's ,Telemedicine etc. , if the Provider is IN or OUT of network , how much the deductible , copay , coinsurance and out of pocket that the Member will pay ( if there is ) and if the plan is still active or not.  
- Prior Authorization : ensure that Prior Authorization is needed or not prior to appointment.  And or advice Providers to obtain Retro Authorization if they are unable to obtain one before the service is delivered .
- Claims : provides information about the claim , how much did it pay ,or why no payment made or  as to why claim got denied , and discuss options how it can get paid .  
- Appeals : provide accurate information to Providers about the status of Appeals and turn around time and detailing the reasons about the delay and follow up via email with the appeals team.
- Telephone operator : inbound calls from Providers and Members requesting to be connected/ transferred directly to Provider lines or Member lines . 

WORKER SKILLS
TOP SKILLS
  • Speaking
  • Sales Representative
  • Customer Support
  • Phone Support
  • Medical Services

English
SKILL RATING
  • Speaking

Sales and Marketing
SKILL RATING
  • Sales Representative

Customer Service & Admin Support
SKILL RATING
  • Customer Support
  • Phone Support

Professional Services
SKILL RATING
  • Medical Services

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