Job Title: Customer Service Representative (US Healthcare Voice)
Role Objective To act as a primary point of contact for US-based members or providers, delivering high-quality support regarding health insurance benefits, claims, medical billing, or appointment scheduling while ensuring 100% compliance with healthcare regulations.
Key Responsibilities
- Call Handling: Manage inbound and/or outbound calls professionally. This may include verifying insurance coverage, explaining plan advantages, or assisting with claim status.
- Issue Resolution: Troubleshoot and resolve complex billing discrepancies, authorization issues, or enrollment queries.
- Data Management:
Accurately document all interactions in the CRM (Customer Relationship Management) system in real-time.
- Compliance (HIPAA): Maintain the highest level of confidentiality and security for Protected Health Information (PHI) as per US federal guidelines.
- Provider Coordination: Communicate with doctors offices, hospitals, and pharmacies to verify medical necessity or facilitate "Prior Authorizations."
- Performance Metrics: Meet or exceed Daily/Weekly targets related to AHT (Average Handling Time), CSAT (Customer Satisfaction Score), and Quality Scores.
📌 Walk-in || Customer Service Executive (Pune)
🏢 XBP Global
📍 Pune
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