Native Korean Health Insurance Support at SuperStaff

, , Philippines -

Full Time

Start Date

Immediate

Expiry Date

21 Feb, 26

Salary

110000.0

Posted On

24 Nov, 25

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Fluency In Korean, Fluency In English, Problem-Solving Skills, Customer Focus, Attention To Detail, Critical Thinking, Collaboration, Health Insurance Knowledge, Technical Skills

Industry

Outsourcing/Offshoring

Description

Korean Customer Service Representative (CSR) to support our Korean- speaking health insurance clients. As a CSR, you will handle more complex inquiries and escalations related to health insurance policies, claims, and disputes. You will act as a resource for resolving intricate issues that require in-depth knowledge of insurance processes and policy details. Fluency in both Korean and English is essential, along with strong problem-solving skills and a customer-focused mindset. Advanced Customer Support: o Handle escalated and complex inquiries from Korean-speaking customers via phone, email, and chat. o Assist with detailed questions related to health insurance plans, including policy terms, exclusions, coverage limits, and claims processes. o Provide personalized support to resolve customer issues related to claim denials, policy disputes, and billing discrepancies. o Act as a point of contact for customers needing advanced assistance beyond support. Claims Resolution and Policy Management: o Investigate and resolve escalated claims issues by coordinating with the claims, underwriting, and billing departments. o Offer detailed explanations of denied claims, guiding customers through the appeals process if necessary. o Support customers in understanding and utilizing their policy benefits, deductibles, co-pays, and out-of-pocket expenses. Escalation Handling and Case Management: o Manage customer escalations professionally and efficiently, ensuring timely and accurate resolutions. o Document all escalated cases in the CRM system, including detailed notes on the issue, resolution steps, and outcomes. o Follow up with customers to ensure satisfaction and confirm that their issues have been fully resolved. Collaboration and Feedback: o Collaborate with internal teams (claims, billing, and product teams) to address more complex customer needs and policy adjustments. o Provide feedback on recurring customer issues and offer suggestions for process improvements. o Mentor CSRs by sharing knowledge, best practices, and assisting with challenging cases. Compliance and Confidentiality: o Ensure that all communications and processes comply with industry regulations, such as HIPAA, and protect the confidentiality of customer information. o Adhere to company policies and legal requirements regarding health insurance products and services. Continuous Improvement: o Stay up-to-date with changes in health insurance policies, products, and regulatory guidelines. o Participate in ongoing training and development programs to enhance customer service skills and knowledge of insurance offerings. Language Proficiency: Native or fluent in Korean (speaking, reading, and writing) and proficient in English.  Experience: 2-3 years of experience in a customer service role, preferably in health insurance or the healthcare industry.  Health Insurance Knowledge: In-depth understanding of health insurance policies, claims processes, and billing procedures is required.  Problem-Solving Skills: Strong analytical skills to diagnose and resolve complex customer issues.  Technical Skills: Experience with CRM systems, call center software, and case management tools. Key Competencies  Customer Focus: Demonstrates empathy and provides thoughtful solutions for complex customer issues.  Attention to Detail: Ensures accuracy in documentation, claims processing, and reporting.  Critical Thinking: Ability to analyze problems and recommend effective solutions quickly.  Collaboration: Works well with internal teams to resolve escalations and improve customer service processes. HMO with 1 free dependent upon hire Life Insurance Work onsite Night Shift (10% Night Differential) 20 PTO credits upon regularization Great Company Culture Career Growth and Learnings Php 110,000

Responsibilities

As a Korean Customer Service Representative, you will handle complex inquiries and escalations related to health insurance policies, claims, and disputes. You will provide personalized support to resolve customer issues and act as a resource for intricate insurance processes.