Customer Care Associate for Helpline  

Responsible for prompt, accurate and effective handling of healthcare-related telephone inquiries and concerns.

Duties and Responsibilities

• Handles explanation of benefits and limitations of coverage to members for inpatient and outpatient availments through calls, texts, and emails.
• Receives, attends to, and records telephone inquiries, concerns and feedback; elevates complex complaints from clients to immediate superiors.
• Coordinates with Liaison officers and backroom staff in order to effectively address client concerns.
• Issues Letter of Authority/control number for hospital admissions and releases diagnostic control numbers for approved diagnostic procedures.
• Pouches outpatient forms to all providers Monitors, records data, and checks status, benefits and medical records of admitted patients.
• Monitors in-patient admissions in areas without liaison officers.
• Accountable in providing correct approvals for in and outpatient availment
• Provides delivery of courteous, fair, prompt, and effective service to customers.
• Provides assistance/support in directing issues or concerns related to other Cocolife Health care departments.
• Provides documentation and resolution of customer concerns coming from phone calls, text messages, and emails.
• Provides assistance/support to liaison officers in determining inpatient approvals that is appropriate in relation to the member’s schedule of benefits.

• Strong analytical and planning skills;
• Good presentation skills;
• Excellent problem-solving skills;
• Excellent listening and oral communication skills
• Service orientation and relationship management skills