Customer Service Advocate | Medical & Dental Claims | WFH
Healthcare Customer Service Advocate (Medical & Dental Claims | Remote) Join a team that makes a real difference in people’s lives—one call at a time. If you’re passionate about healthcare, have an eye for detail, and thrive in a fast-paced environment, this is your opportunity to grow your career while working from the comfort of your home! About the Role: As a Healthcare Customer Service Advocate, you’ll be the trusted voice for our members, providers, and partners—delivering expert guidance on medical and dental claims, benefits, and coverage. You’ll use your knowledge of healthcare processes and coding (ICD-9 & ICD-10) to ensure accuracy, empathy, and efficiency in every interaction. This role is perfect for someone who takes pride in solving problems, supporting others, and continuously learning in the ever-evolving healthcare industry. What You’ll Do: Customer Support
- Be the first point of contact for members, providers, and partners—via calls or chat—in full compliance with HIPAA standards.
- Deliver clear, accurate information on coverage, eligibility, benefits, limitations, and exclusions.
- Collaborate with internal departments (Eligibility, Benefits, Claims, and more) to ensure complete resolution of inquiries.
- Stay informed about products, policies, and industry trends to provide best-in-class support.
Claims Processing
- Handle a high volume of claims efficiently and accurately.
- Review policy details, documentation, and medical records to determine eligibility and payout.
- Support members through grievances and appeals, ensuring fair and transparent resolutions.
- Communicate updates clearly with claimants, healthcare providers, and internal teams.
Data Management & Quality
- Document every interaction with precision and care.
- Identify recurring issues and help drive process improvements.
- Uphold quality and compliance standards to ensure customer satisfaction.
- Assist members with website navigation and troubleshoot access issues.
Work Requirements
- Associate degree or equivalent experience (preferred)
- 2+ years in BPO Healthcare (Voice), with focus on Provider Services
- Strong knowledge of healthcare processes, medical/dental claims, ICD-9 & ICD-10 coding, eligibility, and benefits
- Excellent multitasking, analytical, and communication skills
- High attention to detail and accuracy
- Tech-savvy: proficient in MS Office and online systems
- Ability to work flexible shifts, including nights, weekends, and holidays
- Located in or near Manila (preferred)
- *Work Arrangement: This position is currently offered on a REMOTE work basis after successful completion of training. However, please note that this is a performance-based role, and the company reserves the right to require employees to report onsite at any time based on business needs, performance evaluations, operational requirements. Flexibility to transition to an office-based setup when necessary is expected.
WORK FROM HOME REQUIREMENTS
* • High Speed Internet of 25MBPS download and 5MBPS upload. You will be required to provide a speed test.
- Ability to directly hardwire to your modem
- Required to have a quiet dedicated work area.
Why You’ll Love Working with Us:
- Remote Setup
- Competitive Pay + 13th Month Salary
- Comprehensive HMO Coverage (Medical & Dental)
- Equipment Provided – Everything you need to succeed
- Career Growth – Be part of a dynamic and supportive team that values your expertise
- ⚡ Immediate Hiring – Start ASAP and make an impact from day one
Be the Difference. Apply Today! Take the next step in your healthcare career—where your skills, empathy, and professionalism truly matter. COMPANY OVERVIEW: Imagenet is a leading provider of back-office support technology and tech-enabled outsourced services to healthcare plans nationwide. Imagenet provides claims processing services, including digital transformation, claims adjudication and member and provider engagement services, acting as a mission-critical partner to these plans in enhancing engagement and satisfaction with plans’ members and providers. The company currently serves over 70 health plans, acting as a mission-critical partner to these plans in enhancing overall care, engagement and satisfaction with plans’ members and providers. The company processes millions of claims and multiples of related structured and unstructured data elements within these claims annually. The company has also developed an innovative workflow technology platform, JetStreamTM, to help with traceability, governance and automation of claims operations for its clients. Imagenet is headquartered in Tampa, operates 10 regional offices throughout the U.S. and has a wholly owned global delivery center in the Philippines. Apply tot his job Apply To this Job