Job Description

We have Openings for US Health Care Customer Service Representative Management Process. As a healthcare Customer Service Representative, you will be responsible for successfully managing large amounts of inbound and outbound calls. This will include following communication scripts, handling different topics, and acting as a liaison between our company and its customers. In addition, you will be responsible for evaluating all documents to ensure that appropriate information has been obtained for claim purposes.

Qualification: Any Graduate

Experience: 2- 5 years of US Healthcare Calling Experience.

Responsibilities:

- Manage Inbound & Outbound calls and customer service enquiries, in this profile specifically agent will be answering an inbound calls which they will receive from the providers/pharmacies/members to seek assistance on benefits or on claim denials.
- US Medical/PBM denied Claims Handling process.
- Utilization Management handling including PA, Appeals, etc.
- RCM cycle that is used to manage the financial cycle of a patients encounter.
- Management and resolve customer complaints
- Identifying customers needs, clarify information, research every issue and providing solutions




- Following call centre “scripts” when handling different topics
- Work with the team to resolve issues with valuable aptitude
- Maintain and prepare activity reports.
- Maintains and improves quality results by adhering to standards and guidelines, recommending improved procedures

Requirements:

- Previous experience in US Healthcare.
- Should be comfortable with rotational shifts and offs.
- Should be comfortable with working on Indian Holidays.
- Should be well versed with end to end claims handling process.
- Strong phone and verbal communication skills along with active listening
- Familiarity with CRM systems and practices
- Customer focus and adaptability to different personality types
- Ability to multi-task, set priorities and manage time effectively

Mandatory Skills/Experience:

- Excellent communication skills (written and verbal).
- American accent would be preferable.
- Should be comfortable with rotational shifts and offs.
- Should be comfortable with working on Indian Holidays.
- Candidates must be willing to work in Voice process.

📌 Walk-in || Urgently Required | Customer Support Representative | WFO Only (Noida)
🏢 Rxadvance Pbm
📍 Noida