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Full-time
associate degree
Posted 22d ago
~40 hrs/week
Responsibilities
The role involves assisting beneficiaries with account updates, plan information, and resolving billing or prescription claims issues. The advocate must maintain high call quality standards and ensure compliance with HIPAA and CMS regulations.
Requirements
Candidates should have an Associate Degree, preferably in Healthcare, and at least 3 years of experience in a high-volume call center or customer service environment. Proficiency in Microsoft Office and the ability to handle complex customer needs with empathy and professionalism are required.
Full job description
About Us
Helpware is a technology-driven company with offices in the USA, Ukraine, Mexico, and the Philippines which provides Customer Experience & Operational Support for modern companies. Our team of professionals is driven by the purpose of providing best-in-class value-adding services to our partners by leveraging our empowered teams, innovative solutions, and technologies.
Position Summary:
As a Member Services Advocate, you will be a part of a team that transforms customer service into Customer Care by delivering an amazing experience. You will assist beneficiaries with a wide range of critical services, which include but not limited to updating account information, providing plan information, resolving issues with utilization of the plan. Qualified candidates will have a strong desire to help people with strong customer care skills, attention to detail, and highly organized.
Responsibilities:
As our customers share concerns and provide us with valuable feedback, your ability to recognize and complete the steps necessary to meet their needs will leave a permanent, lasting impression of the passion you have for helping them be at their best. We make sure our customers are not alone when it comes to understanding their benefits and they will rely on you to advocate for them as you would your own family member. In addition to the keys to success identified above that you will bring with you to the team, you will need to demonstrate the following abilities:
Update account information such as billing options and changes of address or phone numbers.
Research premium billing discrepancies and prescription claims processed.
Educate beneficiaries on how the plan works, including benefits, cost sharing, and levels of coverage.
Submit mail requests for beneficiaries such as ID cards and formularies.
Look up medicines on the formulary to verify if they are covered, the tier and copay level, and if a drug is not covered, provide an explanation as to why.
Displays positive demeanor, technical accuracy, and conformity to company policies.
Understands CMS Guidance and ensures applicable Exhibits are being mailed per CMS Guidance.
Ensure HIPAA regulations are maintained within the immediate environment.
Responsible for concise and detailed notations as it pertains to member records.
Handles outbound calls for purposes of validating information.
Handles inbound calls by assisting members with a high level of accuracy and efficiency.
Escalates any member issues to management as necessary.
Responsible for maintaining a high level of call quality as set by client standards, which includes a 95% quality score, and answering 80-85% of calls within 30 sec. or less
Communicate with coworkers, management, staff, customers, and others in a courteous and
professional manner.
Conform with and abide by all regulations, policies, work procedures and instructions.
Respond promptly when returning telephone calls and replying to correspondence and faxes.
Act, dress, and behave in a professional manner to reflect a positive image of the company.
Monthly Goals:
Meet average QA score of 95%
Comply with attendance guidelines of 98%
Schedule adherence of 90% or higher
Maintain AHT below certain standards
Requirements:
Associate Degree preferably in Healthcare
Minimum 3 years working in a fast paced high volume call center environment, retail customer
service, preferably in healthcare or hospitality
Ability to multi-task effectively with strong attention to detail when documenting customers reasons for calling
Excellent written communication skills
Excellent problem-solving abilities - Must love customer service with excellent listening skills,
demonstrate empathy and the ability to educate customers
Ability to de-escalate matters in a calm and professional manner
Comfortable with technology and navigating numerous systems simultaneously
Unwavering dedication to serving a customer that has complex needs
Requires strong technical skills with Microsoft Office (Excel, word, and Outlook)
Must have an energetic phone presence - professional etiquette over the phone, through written and face to face communication
Self-motivated, confident, reliable and commitment to customer satisfaction
Adherence to following internal policy
Ability to interact professionally and maintain effective working relationships with superiors, coworkers, customers, and others
Ability to break down complicated information into simple messages for the caller
Delivering business transformation through AI-enabled BPM: measurable results, human expertise.
Industry
Outsourcing/Offshoring
Company size
1,001-5,000 employees
Founded
2015
Headquarters
Lexington, Kentucky
LinkedIn followers
18,246
Helpware is built to help the world’s most innovative brands scale faster, smarter, and more sustainably. We combine the precision of AI-enabled BPM with the dedication of world-class teams to deliver measurable results across customer experience, technology, and growth marketing. Our approach is simple: the right people, the right process, powered by the right technology, working seamlessly to transform your business.
Offices: 110 W Vine St, 5th Floor Ste 17, Lexington, Kentucky 40507, US · 548 Market St, San Francisco, California 94104-5401, US · Kiev, Ukraine 04070, UA · 26th McKinley Parkway, Metro Manila, Taguig 1630, PH · Avenida de las Américas 1254, 16th floor, Guadalajara, Jalisco 44610, MX
BPMBPOAI transformationOutsourced customer serviceCustom software developmentand Digital transformationAccountingSoftwareDeveloper APIsData Collection and Labeling
How many Customer Service & Support jobs are open in Cebu, Philippines right now?
There are currently 79 open customer service & support positions in Cebu, Philippines listed on Clera. New openings are added daily as companies post roles.
Which companies are hiring for Customer Service & Support roles in Cebu, Philippines?
Companies currently hiring include Helpware, Newfold Digital, AvePoint, Momentive, SMDigital Partners, among others. Browse the listings above to see every active employer.
Are there remote or hybrid Customer Service & Support jobs in Cebu, Philippines?
Yes — 32 of the 79 open customer service & support positions offer remote or hybrid work (15 remote, 17 hybrid).
How do I apply for Customer Service & Support jobs in Cebu, Philippines?
Each listing links directly to the employer's application page. Apply early — fresh listings get the most recruiter attention in the first two weeks.