Membership Service Advocate (N4)

About the role

The Membership Service Advocate (N4) will join Helpware’s customer care team in Cebu, providing essential support to beneficiaries by updating account information, explaining plan details, and resolving utilization issues.

Key responsibilities

• Update account details such as billing options, address, and phone numbers.
• Research premium billing discrepancies and prescription claims.
• Educate beneficiaries on plan benefits, cost sharing, and coverage levels.
• Process mail requests for ID cards, formularies, and other member documents.
• Verify medication coverage on formularies and explain non‑coverage reasons.
• Handle inbound and outbound calls with high accuracy and efficiency.
• Maintain detailed member records and ensure HIPAA compliance.
• Achieve quality metrics: 95% QA score, 80‑85% calls answered within 30 seconds.

Required profile

• Associate degree, preferably in Healthcare.
• Minimum 3 years in a fast‑paced, high‑volume call‑center or customer‑service environment.
• Strong attention to detail, excellent written communication, and problem‑solving abilities.
• Ability to de‑escalate issues calmly and demonstrate empathy.
• Self‑motivated, reliable, and committed to customer satisfaction.

Required skills

• Proficiency with Microsoft Office applications (Excel, Word, Outlook).