Job description
Maxicare, a leading health maintenance organization in the Philippines, invites applications for a Customer Support Associate who has graduated from a Medical Allied program. Based in Taguig at PCC BGC, you will be the frontline ambassador for members and healthcare partners, delivering empathetic, expert guidance that makes everyday healthcare simpler. This role blends clinical knowledge with customer service excellence to support enrollment, benefits verification, claims assistance, and overall member satisfaction.
As a Medical Allied Graduate, you will interpret complex benefit information into clear, actionable guidance for members. You will collaborate with internal teams to resolve inquiries promptly, maintain precise records, and promote Maxicare services and self-service options. If you are passionate about healthcare access and helping people navigate their benefits, this is the position for you. Maxicare offers comprehensive training, clear growth paths, and a collaborative environment that values accountability, teamwork, and patient-centered care.
Join us to make a real impact on daily healthcare experiences. Your contribution will help members access the care they deserve with confidence, efficiency, and care.
Responsibility
- Provide courteous, professional frontline support to Maxicare members and partner providers via phone, email, and chat.
- Verify member information and benefit eligibility; assist with enrollment changes, plan questions, and eligibility updates.
- Support claims processes, including pre-authorization and referrals, ensuring accurate updates in the CRM.
- Maintain accurate member records, document interactions, and ensure data integrity for seamless service delivery.
- Troubleshoot issues, escalate complex cases to the appropriate teams, and follow up to ensure timely resolution.
- Collaborate with Claims, Medical Operations, and Network teams to resolve inquiries and share knowledge for better service outcomes.
- Educate members on plan benefits, usage guidelines, and available self-service options to maximize value from coverage.
- Adhere to service standards and quality metrics, contributing to a positive member experience and strong brand reputation.
Qualification
- Graduate of Medical Allied programs (Nursing, Medical Technology, Pharmacy, Radiology, or related fields).
- Basic understanding of healthcare insurance concepts, benefits, and common medical terminology.
- Excellent verbal and written communication skills in English and Filipino.
- Empathetic, patient-focused with strong problem-solving abilities.
- Proficiency in MS Office and familiarity with CRM systems or healthcare software.
- Ability to multitask in a fast-paced environment and work flexible shifts, including weekends or holidays as needed.
- Previous customer service experience is a plus; a collaborative, proactive mindset is highly valued.