MEMBER SERVICES SPECIALISTS

(General Santos city based)

Responsibilities and Duties:

Facilitates administration of health benefits to all HMO members/card holders through proper coordination between the patient and the provider.
Maintains hospital & doctors databases.
Addresses the questions and concerns of patients, families, and staff members.
Investigates delays in treatment and effectively resolves any patient-physician issues or disputes.
Handles all inquiries, concerns, and requests of member relative to their health benefits.
Coordinates with the Billing/Collection Department of accredited hospitals regarding the status of confined client-member/s regarding the coverage of the confined client-member/s.
Responsible for the coordination of checks and payments of/for all accredited hospitals and doctors.

Skills and Qualifications

Bachelor's degree in nursing
Knowledgeable in hospital protocols and procedures
Willingness to promote health and maintenance programs
Ability to create a safe and comfortable environment for patients and staff
Excellent communication skills
Ability to control emotions and remain objective during disputes and investigations
Previous experience working in a medical setting
Able to work individually or in a team
Ability to handle complaints or challenging situations confidently.
Broad understanding of patient confidentiality laws
Willing to start ASAP

Member Services Specialists