Fatma Elzahraa Gamal Mohamed

Customer Care AgentFull Time

• Job Details:Providing support and assistance to customers regarding their health insurance policies, claims, and general inquiries. Handle customer complaints and resolve issues related to approvals, coverage disputes, billing errors, and claim denials. Ensure that customers feel heard and that their concerns are addressed promptly. Help with payment issues, such as missed payments, payment arrangements, or refund requests. Clarify any charges or deductions on the customer’s statements. Educate customers about the benefits of their medical insurance plan, helping them utilize it to the fullest (e.g., finding in-network providers, preventive care). Maintain accurate customer records, including call logs, claims, policy updates, and follow-up actions.

Medical Customer SupportFull Time

• Job Details:Assist customers in navigating and understanding their TPA medical benefits. Address inquiries related to claims processing, coverage details, and authorization procedures. Collaborate with TPA service providers to ensure seamless coordination of medical services. Investigate and resolve customer inquiries regarding claim discrepancies or delays. Communicate effectively with internal teams and external partners to expedite claims processing. Manage and resolve customer complaints, ensuring timely and satisfactory resolution. Identify and escalate issues to supervisors as needed. Provide comprehensive product and service information to customers. Conduct research using available resources to address customer inquiries. Utilize applicable software to identify and resolve customer complaints. Process orders, forms, and applications accurately and efficiently. Document all call information following standard operating procedures. Recognize, document, and alert the management team about trends in customer calls. Follow up on customer calls when necessary to ensure customer satisfaction. Up-sell services to enhance customer experience and meet business objectives. Complete call logs and reports to track and analyze customer interactions. Maintain accurate and up-to-date records of customer interactions in the TPA database.

Senior Customer Care OfficerFull Time

• Job Details:Working on taking a patient-centric perspective, viewing them as people our company is meant to help. Owning accurate and complete patient information, providing them access to the right medical records, streamlining and integrating healthcare data across workflows, and keeping sensitive patient data protected. Demonstrate to the patient that the facility cares about his or her health and experience by making a follow-up phone call to check how the patient is feeling which indicates personal attention and to evaluate our progress. Offer instant and accurate responses by setting up automated workflows within our support software helps us responding to our patients faster, whether it's an inquiry about billing or a quick call to check the availability of a doctor. Being proactive in anticipating patient needs and helping them without causing anxieties or frustrations. Reply to patients' inquiries via whatsapp and make sure to deliver the exact information they need. Evaluated customer feedback data and identified areas for improvement in customer service policies and procedures. Doing test calls regularly with the medical providers to make sure that the service is active helping to update the medical network.