Job Summary

Outbound call responsibilities encompass contacting insurance companies, verifying eligibility with end customers, obtaining prior authorization, requesting missing or incomplete payer information, updating patient information, and performing other necessary communications to complete transactions.

Inbound call handling requires collaboration as part of a team to deliver professional customer service through various communication channels, with the objective of resolving customer inquiries, processing payments, and addressing complaints at the first point of contact whenever possible.

Key Responsibilities

• Assess and resolve enquiries, requests, and complaints primarily via telephone, ensuring customer enquiries are addressed at the first point of contact.
• Utilize sound judgment and make decisions within established procedures for each service request, including logging, processing, and monitoring enquiries. Adhere to agreed Key Performance Indicators, Service Level Agreements, and quality standards to maximize customer satisfaction.
• Provide customers with product and service information and offer upsell opportunities when applicable during interactions.
• Manage and update account-wise customer interactions daily, generated through workflows and queues.
• Achieve key and critical performance targets.
• Ensure efficiency measures are met in accordance with performance targets and process guidelines.
• Participate as an active member of the customer service team.
• Use business tools and industry knowledge updates to identify problem areas and document business requirements through various updates and training sessions.
• Maintain effective work procedures as per client process workflows and HCL policy guidelines.
• Adhere to US healthcare compliance measures.

Skill Requirements

• Strong verbal and written communication skills
• Focus on delivering a positive customer experience 
• Should possess active listening skills
• Good data entry & typing skills
• Ability to multitask.
• Ability to contribute to the process through improvement ideas.
• Analytical and problem-solving skills on the process.
• To use sound judgment and take decisions.

Other Requirements