Onsite Customer Service Representative (Healthcare) at Qualfon Philippines Incorporated

Casselberry, Florida, United States -

Full Time

Start Date

Immediate

Expiry Date

19 Feb, 26

Salary

16.0

Posted On

21 Nov, 25

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Customer Service, Healthcare, Communication Skills, Computer Skills, Problem Solving, Empathy, Reliability, Flexibility, Typing, Claims Resolution, Benefit Explanation, Appointment Scheduling, Care Coordination, Documentation, Team Collaboration, Health Campaigns

Industry

Outsourcing and Offshoring Consulting

Description

Overview Join Our Team – Assisting customers with their Health Benefits! We are seeking a compassionate, service-oriented Member Advocate to join our team and support members in navigating the healthcare system. As the first point of contact, the Member Advocate provides personalized, high-quality support to help members understand their health benefits, access essential services, and coordinate care. The ideal candidate thrives in a fast-paced, multi-channel environment and is passionate about making a meaningful difference in the lives of others. Must be able to work onsite: 105 Live Oaks Gardens, Casselberry, FL 32707** Why You Will Love Working Here: Meaningful work that genuinely helps people. Consistent weekday schedule – no weekends required! A supportive team that prioritizes empathy and excellence. Opportunities for growth within a stable, respected organization. Ready to Make a Difference?If you're passionate about helping others, apply today and join a team where your voice matters! Responsibilities What You’ll Do: Serve as a single point of contact for members, building trusted relationships and assisting with provider access, appeals, claims, and services. Explain plan benefits and resolve claims and benefit issues via phone or digital communication. Ask questions to identify member needs, including those outside their current benefits. Handle inbound and outbound inquiries through phone, email, mail, and chat. Help schedule appointments, arrange transportation, find providers, issue ID cards, and guide members in using online tools. Proactively reach out to members for health campaigns and wellness follow-ups. Coordinate with providers, Care Managers, and vendors; warm transfer members and remain on the line if needed to ensure resolution. Work closely with internal teams and healthcare providers to resolve issues and ensure a smooth member experience. Document actions taken and communicate follow-up timelines to members. The Training Hours: 11:00am-8:00pm EST Monday-Friday Hours of Operation:11:00am-11:00pm EST Monday-Friday Qualifications What You’ll Bring: High school diploma or GED required, college coursework a plus. Must be at least 18 years of age. 1+ year of customer service experience (call center and/or healthcare preferred). Typing speed of 25 WPM with 90% accuracy required. Strong communication skills—clear, caring, and professional. Solid computer skills, including MS Office and navigating the web. Reliability, flexibility, and a commitment to getting the job done right. If you would like to fill out a Voluntary Self-Identification of Disability Form. Please visit us at Qualfon.com/join-us EQUAL OPPORTUNITY STATEMENT QUALFON is an equal opportunity employer. QUALFON provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sex (including pregnancy, childbirth and related medical conditions), sexual orientation, gender identity, national origin, age, disability, genetic information (including testing and characteristics), marital status, ancestry, status as a covered veteran, uniformed servicemember status and any other characteristic protected under applicable federal, state or local law. Qualfon is an equal employment opportunity employer. Alternative methods of applying for employment are available to individuals unable to submit an application through this site because of a disability. Contact qualfon-dialogdirectrecruiting@qualfon.com to discuss reasonable accommodations. Pay Range USD $16.00 - USD $16.00 /Hr.

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Responsibilities

Serve as a single point of contact for members, assisting with provider access, appeals, claims, and services. Explain plan benefits and resolve claims and benefit issues through various communication channels.