Remote Healthcare Service Advocate (Provider Services)

TL;DR

Remote Healthcare Service Advocate (Provider Services): Managing healthcare provider inquiries regarding claims, appeals, and payments with an accent on accuracy, compliance, and professional communication. Focus on resolving complex claim issues, maintaining high service standards, and ensuring seamless administrative support within a fast-paced contact center environment.

Location: Must be based in or near Manila, Philippines. While currently remote, the role requires flexibility to transition to an office-based setup in Makati City if business needs dictate.

Company

hirify.global is a leading provider of back-office support technology and tech-enabled outsourced services for healthcare plans, processing millions of claims annually through its innovative workflow platform.

What you will do

• Handle provider inquiries via email, fax, and web regarding claims, payments, and appeals.
• Provide accurate claim status updates and explain outcomes based on company guidelines.
• Research and resolve complex claim issues by coordinating with internal departments.
• Process faxed claims and review Explanation of Benefits (EOBs).
• Document all customer interactions accurately in the system while maintaining HIPAA compliance.
• Meet established service level agreements (SLAs), quality, and productivity metrics.

Requirements

• Must be located in or near Manila, Philippines.
• At least 4 years of experience in a healthcare contact center, provider services, or claims support environment.
• Proficiency in MS Office and online systems.
• Stable primary internet connection of at least 50Mbps with a reliable backup.
• Ability to work flexible shifts, including nights, weekends, and holidays.
• Excellent analytical, multitasking, and communication skills.

Nice to have

• College degree.
• Basic knowledge of healthcare claims, EOBs, appeals, and payment processes.

Culture & Benefits

• Competitive pay with 13th-month salary.
• Comprehensive HMO coverage for medical and dental.
• Equipment provided for remote work.
• Opportunity for career growth in a dynamic, supportive team.
• Immediate hiring process.