Job Summary

We are looking for a customer-focused and service-oriented Customer Experience Associate to provide exceptional support to members by addressing inquiries related to healthcare benefits, Letter of Authorization (LOA) issuance, policy coverage, approval status, exclusions, and other HMO-related concerns. The ideal candidate is an excellent communicator who thrives in a fast-paced environment and is committed to delivering high-quality customer service.

Key Responsibilities

• Provide prompt and accurate assistance to members regarding benefit utilization, LOA issuance, policy coverage, approval status, exclusions, and other related inquiries.
• Handle member complaints and feedback professionally, ensuring timely and appropriate resolution.
• Meet established service-level agreements (SLAs) by maintaining high productivity and quality standards.
• Coordinate with the technical team, insurance providers, brokers, and healthcare service providers to address member concerns and ensure efficient service delivery.
• Maintain accurate records of customer interactions and transactions.
• Perform other duties and ad hoc tasks as assigned by management.

Qualifications

• Diploma, Advanced/Higher/Graduate Diploma, Bachelor's Degree, or Professional Certificate in Insurance or any related field.
• Experience in the HMO, Third-Party Administration (TPA), call center or healthcare
• Excellent verbal and written communication skills in both English and Filipino.
• Strong customer service, problem-solving, and interpersonal skills.
• Ability to work independently and efficiently in a fast-paced environment.
• Proficient in Microsoft Office applications (Word, Excel, Outlook, and PowerPoint).
• Willing to work on shifting schedules.