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 advantages 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.
Solid 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