Premium Healthcare CSR, Quezon City

We are looking for a Senior Member Advocate who operates at the intersection of high-level technical expertise and profound human empathy. In this role, you arent just answering questions; you are a master navigator of the complex U.S. healthcare landscape. You will serve as the primary architect of resolution for our members, turning convoluted clinical and financial hurdles into clear, actionable paths forward.

• Complex Problem Solving: Own the end-to-end resolution of intricate claims disputes, billing discrepancies, and benefit gaps using advanced analytical thinking.
• Clinical & Benefit Navigation: Guide members through complex health conditions, helping them understand their coverage, provider networks, and specialized care programs.
• Active Advocacy: Act as the bridge between the member, providers, and internal clinical teams to ensure seamless care delivery and administrative accuracy.
• Strategic Relationship Building: Establish immediate rapport with members through active listening, curiosity, and a proactive "total solution" mindset.
• Resource Application: Expertly leverage internal databases, regulatory guidelines, and healthcare resources to provide definitive answers and support.

• College Background: Completion of at least two (2) years of college (undergraduate level).
• Alternative Path: Senior High School (SHS) Graduates are eligible to apply if they possess a minimum of two (2) years of relevant professional experience.

• Contact Center Foundation: A minimum of one (1) year of experience within a Contact Center environment.
• Healthcare Specialization: Previous experience within the Healthcare sector is highly preferred and will be a significant advantage.

The ideal candidate will have a career history that balances technical healthcare knowledge with versatile service skills, specifically:

• 80% Healthcare Focus: Substantial background in medical claims, health insurance navigation, or clinical member support.
• 20% Non-Healthcare Focus: General customer service experience that demonstrates adaptability and a well-rounded skill set.