Customer Care Staff [Medlinx]

Responsibilities

Provide clear explanations of insurance/ASO policy terms and conditions to members. Assist members in understanding the claim workflow and required steps. Interpret basic medical diagnoses and doctor’s notes to support inquiry handling. Manage inbound and outbound calls, including questions, requests, and escalations. Operate TPA/ASO back-end systems and call center operational tools. Handle member complaints with professionalism and appropriate problem-solving. Deliver empathetic, clear, and effective communication to insurance participants. Work in a shift-based schedule according to operational needs.

Requirements

Healthcare-related educational background (any discipline) with the ability to understand diagnoses and medications is an advantage. Experience working in health insurance, TPA, or ASO is preferred. Familiarity with TPA/ASO back-end systems and call center tools. Strong communication skills with a customer-focused approach. Experience in complaint handling and conflict resolution. Willing to work in shift schedules.