38 Case Management jobs in the Philippines

ISTA Solutions, an outsourcing/offshoring company, is in search of an experienced HEALTHCARE CUSTOMER SERVICE REPRESENTATIVE to join our rapidly expanding team. As a member of our team, you will have the opportunity to work with highly skilled professionals, who prioritize employee satisfaction and work-life balance. At ISTA Solutions, we pride ourselves on creating a culture focused on long-term success and life-long learning. We're looking for a team player who is ready to contribute to our mission, just like you

Account specific roles and responsibilities:

• Administer medications, treatments, and medical procedures as prescribed by healthcare providers. Monitor vital signs and assist with wound care, IV therapy, or other medical interventions.
• Maintain accurate and up-to-date patient records, documenting care provided, changes in condition, and any incidents or concerns.
• coordinates with US insurance providers

Job Description:

• Provides customer support through different communication channels (Phone, email, chat).
• Resolve issues & accommodate customer inquiries to ensure satisfaction with products or services.
• Collaborate with colleagues and different departments to resolve complex issues
• Maintain accurate records on customer interactions, transaction, feedback, etc.

• Basic knowledge about Medicare and Medicaid
• 1 year BPO Healthcare Experience related to reviewing medical records, authorization, claims, denials and appeals.
• Good to excellent communications (both verbal & written) and detail oriented
• Ability to multitask (taking in calls and responding to email)
• Organized and keen attention to details
• Familiar with common medical terms
• Willing to report onsite in MAKATI
• Amenable working night shifts

What can we offer you?

• Competitive salary and benefits
• Health Insurance with free dependents*
• 10%-night differential
• Attendance Bonus
• Paid time off
• Convertible to cash leave credits
• Performance Appraisal
• Work-life balance
• A focus on growing your career path with us
• We encourage you to follow your passions and learn new skills

Our commitment to you

• Strong culture and values-driven leadership
• We create opportunities for you to learn and grow at any stage of your career
• Continuous learning and innovation
• We foster an all inclusive environment where everyone thrives

Do you want to take the first step in making Filipinos' lives better everyday? Here in GCash we want to stay at the forefront of the FinTech industry by creating innovative, meaningful, and convenient financial solutions for the nation G ka ba? Join the G Nation today

Who You'll Be Working With
If you have a strong background in customer service, communication,t, and are empathetic, people-focused, detail-oriented, and passionate about delivering exceptional customer journeys, then the Customer Experience Management team may be for you
You'll Be Responsible For The Following
Case Escalations Management

• Act as the escalation point for high=priority or complex cases that requires additional attention.
• Ensure escalated cases are handled properly by the vendors swiftly and efficiently minimizing customer dissatisfaction.
• Work to prevent case escalations by identifying and addressing potential issues proactively.

Root Cause Analysis

• Conduct root cause analysis for recurring or complex cases to identify systemic issues.
• Work with Incidents and Problem Mgt Team to address the underlying causes of frequent problems and develop solutions to prevent future cases.
• Use case data and feedback to identify and propose process improvements.

Case Documentation and Reporting

• Maintain accurate and detailed records of case activities, customer interactions, and resolution outcomes.
• Track case metrics and prepare regular reports for stakeholders, highlighting trends, outcomes, and areas of improvement.

Continuous Improvement

• Continually assess and improve case resolution processes to enhance efficiency and customer satisfaction.
• Identify and implement best practices for case management, using lessons learned from past cases.
• Mentor vendors teams to improve their case handling capabilities and performance.

Customer Feedback and Satisfaction

• Monitor customer feedback to assess satisfaction with case resolution outcomes.
• Take corrective actions when customer feedback indicates dissatisfaction with case handling.
• Use feedback to refine case resolution strategies and improve customer service.

What We Offer
Opportunity for career growth and development in the #1 FinTech company in the country Working with a dynamic and highly collaborative team who want to change the game A company that values their people with highly competitive and flexible compensation and benefits package

At Globe, our goal is to create a wonderful world for our people, business, and nation. By uniting people of passion who believe they can make a difference, we are confident that we can achieve this goal.

Job Description
The Case Management Lead is primarily responsible for overseeing, leading, and evaluating the effectiveness of customer-impacting workflows to ensure seamless and efficient service delivery. This role acts as a key partner across internal teams and external stakeholders, driving improvements in workflow design and automation to enhance customer experience and reduce manual, agent-assisted processes.

Duties And Responsibilities

• Primarily responsible for overseeing, leading and evaluating the effectiveness of customer impacting workflows.
• Align and collaborate with Operations and Voice of the customer teams to understand and resolve customer pain points and challenges
• Champion customer experience improvement in CRM workflow management
• Drive automation and system improvement initiatives to lessen agent-assisted transactions and manual processes
• Partners with representatives of other internal and external groups to identify and address workflow design issues
• Identify performance improvements in existing workflows and recommend enhancements
• Identifies and effectively prioritizes workflow design requirements and regularly communicates updates to stakeholders
• Engage key stakeholders and participate with them on monitoring and reporting progress of work streams.
• Define the high level requirements, governance, metrics, and management practices to be used for case management.
• Set overall direction for the team and conduct mobilization team orientation
• Supervise and lead project plans, assign action items as needed, track progress, cascade updates and changes within and outside the CXM organization
• Work closely with other development teams to ensure the end to end solution meet the business requirements
• Be aware of security implications when implementing solutions
• Maintain accountability for the delivery of program capabilities and business results
• Provide regular reporting to management
• Disseminates information to all stakeholders in a manner that will help facilitate and help ensure front liner and customer change management prior launch dates
• Facilitate discussions on system improvements concerning workflow management
• Provides user requirements and follow through to ensure end to end solution is met
• Align with contact center BPOs on workflow challenges, gathers insights and engage them as stakeholders in redesigning CX

KPIs

• NPS

• % Case Resolution

• % Repeat Reduction
• % Reduction in Manual Processes

• % End to end automation in GlobeOne

• Internal Customer Satisfaction

• Individual Development Plan
• CXM Opex

Competencies
Critical thinking to dissect performance issues and identify root causes and solve problems
Strong Orchestration, Consultation, Facilitation And Communication Skills
An ability to work autonomously and collaboratively
Excellent Attention To Detail, With Strong Organizational Skills
Experience in Project Management
Skills
Experience in CRM development and integration preferred

• Soft Skills: Creative Communications, Relationship Development
• Hard Skills: Project/Program Management, Change Management
• Certification/License: Change Management

Equal Opportunity Employer
Globe's hiring process promotes equal opportunity to applicants, Any form of discrimination is not tolerated throughout the entire employee lifecycle, including the hiring process such as in posting vacancies, selecting, and interviewing applicants.

Globe's Diversity, Equity and Inclusion Policy Commitment can be accessed here

Make Your Passion Part of Your Profession. Attracting the best and brightest Talents is pivotal to our success. If you are ready to share our purpose of Creating a Globe of Good, explore opportunities with us.

Job Summary:

The Document Reviewer and Case Management Officer is responsible in reviewing the OPS documentation and handling cases from complaints and dispute filed.

DUTIES AND RESPONSIBILITIES

1. Facilitates the review and verification of the documents of Operator Payment System (OPS) accounts submitted by the branch.

2. Ensures the completeness of OPS documents prior to endorsing for Terminal ID creation.

3. Coordinates with the Product Champions, the branches, and other concerned units for the compliance of required documents.

4. Handles the cases from complaints/disputes filed.

5. Monitors the cases and ensures complaints/disputes were addressed and resolved.

6. Ensure critical records are scanned/uploaded to the Network Attached Storage Server NASSVR.

7. Perform duties and responsibilities required under the latest manual of operations pertaining to the position.

8. Perform other tasks that may be assigned by the Management from time to time.

WORK RELATIONSHIPS

Reports directly to the Branch Operations Support and Control Department Head.

MINIMUM REQUIREMENT

Education Graduate of any Banking related course.

Experience

• Three (3) years relevant experience in Branch Operations particularly in handling client's documents
• Proven experience in handling corporate/business documents
• Background in customer service preferably in managing customer complaints
• Good communication and analytical skills
• Ability to manage multiple cases

Other Skills: Professional Qualities

Results-oriented

• Analytical
• Team worker
• With leadership qualities
• Good interpersonal skills

Technical Skills

• Office management
• Oral & written communication
• Computer Literate

Job Types: Full-time, Permanent

Benefits:

• Health insurance
• Life insurance
• Opportunities for promotion
• Paid training
• Pay raise
• Promotion to permanent employee

Education:

• Bachelor's (Required)

Experience:

• Branch Operations in handling client's documents: 2 years (Required)

Willingness to travel:

• 100% (Preferred)

Work Location: In person

Job Summary:

The Document Reviewer and Case Management Officer is responsible in reviewing the OPS documentation and handling cases from complaints and dispute filed.

DUTIES AND RESPONSIBILITIES

1.    Facilitates the review and verification of the documents of Operator Payment System (OPS) accounts submitted by the branch.

2.    Ensures the completeness of OPS documents prior to endorsing for Terminal ID creation.

3.    Coordinates with the Product Champions, the branches, and other concerned units for the compliance of required documents.

4.    Handles the cases from complaints/disputes filed.

5.    Monitors the cases and ensures complaints/disputes were addressed and resolved.

6.    Ensure critical records are scanned/uploaded to the Network Attached Storage Server NASSVR.

7.    Perform duties and responsibilities required under the latest manual of operations pertaining to the position.

8.    Perform other tasks that may be assigned by the Management from time to time.

WORK RELATIONSHIPS

Reports directly to the Branch Operations Support and Control Department Head.

MINIMUM REQUIREMENT

Education     Graduate of any Banking related course.

Experience

• Three (3) years relevant experience in Branch Operations particularly in handling client's documents
• Proven experience in handling corporate/business documents
• Background in customer service preferably in managing customer complaints
• Good communication and analytical skills
• Ability to manage multiple cases

• Results-oriented
• Analytical
• Team worker
• With leadership qualities
• Good interpersonal skills

• Office management
• Oral & written communication
• Computer Literate

• IMPORTANT ** WATCH THIS QUICK LOOM VIDEO ON HOW TO GET HIRED:

JOB TITLE
Patient Support Specialist
JOB ID
CURIC

INDUSTRY
Medical

LOCATION
LATAM / PH

JOB STATUS
Full Time

WORK SCHEDULE
8:00am to 5:00pm / 9:00am to 6:00pm EST

SALARY
$700/month + monthly and on-time bonuses

TARGET START DATE
ASAP

Role Overview
About the Role
The client is looking for a dedicated and tech-savvy Medical Virtual Assistant to provide essential remote support for patient check-in kiosks used by medical and dental offices. The ideal candidate will be patient, detail-oriented, and capable of working independently while maintaining exceptional communication skills. This role plays a key part in ensuring the smooth operation of technology solutions and delivering a seamless check-in experience for patients.

Key Responsibilities

• Provide real-time support to patients experiencing issues with the check-in kiosks, primarily via chat with the option for video calls.
• Monitor the status of three kiosks simultaneously to identify and troubleshoot issues proactively.
• Document Management: Use a remote desktop to access Electronic Medical Record (EMR) systems, securely capture patient documents (e.g., insurance cards, IDs), and upload them accurately to patient files.
• Ensure proper transfer of documents between kiosk software and EMR platforms, especially when no direct interface exists.

Qualifications & Skills

• Comfortable using remote desktop software and managing multiple digital platforms simultaneously.
• Excellent English fluency, able to hold natural conversations and build rapport with patients and clients.
• Proactive mindset with strong troubleshooting and problem-solving skills.
• High attention to detail, particularly when managing and organizing patient documents.
• Willingness to obtain necessary certifications, including HIPAA and IT security certifications (covered by the company).
• Reliable fiber optic internet connection and a backup power supply for uninterrupted service.
• Strong cultural alignment with the company's values and commitment to professionalism.

Position Summary:

As a Patient Support Specialist you will be responsible for the success of each and every prescription as it moves through our system, from the original prescription to refill. You'll be an expert at helping our patients (customers) navigate their patient portal, explaining their insurance coverage, and assisting them in getting their medication delivered in a prompt manner.

Role and Responsibilities:

• Handle redundant tasks;

• Resolving inbound patient requests over phone, text, and email by reviewing their order details to provide accurate and detailed information

• Reaching out to patients to resolve issues preventing their order from processing

• Partnering with internal and external operational teams to make prescriptions successful

• Assisting patients with and providing best practices to support their success on Phil's platform

• Understand complex systems simply and you frequently find creative solutions

• Understand technology and software applications

• Can explain difficult and nuanced concepts with simplicity and ease verbally and in writing

• Able to demonstrate your ability to disarm others in difficult situations

• Must be incredible teammate and you build up others

Qualifications:

• Passion for helping people

• 1+ year of experience in customer service over phones, email, or live chat

• Healthcare experience is NOT required, but is a plus

• Start up experience is a plus

• Must be ready for a fast-paced and frequently changing environment

Healthcare is usually slow and boring. We believe in its potential to be exciting and entertaining. But changing the healthcare experience is hard – and we're gonna need all the help we can get…

About Eucalyptus

Eucalyptus
(or 'Euc' for short) is an Australian founded digital healthcare company that is on a mission to solve the world's biggest healthcare challenges - think fertility, and behavioural change around chronic conditions such as weight loss, diabetes, and mental health.

Founded in Australia in 2019, we have now helped over 500K patients globally by combining technology, design and operational excellence to help patients access the best clinical support when they need it - wherever they are.

Our 5 clinics (Juniper, Pilot, Kin, Software, & Compound) focus heavily on personalising the experience for different demographics and are powered by a growing team across 5 countries (Australia, UK, Germany, Japan, and the Philippines).

We've raised over AUD$160M in funding from Aussie and Silicon Valley investors who were early backers of Uber, Canva and AirBnb. With plans to launch into several more markets, offline channels, and tackle new conditions.

We're looking to continue building our team of executional weapons who are passionate about healthcare, aren't afraid to work hard, and invest in others through direct and honest feedback. This approach enables us to make the most impactful changes to improve the health of millions of patients globally.

About The Role (What You'll Be Doing)

• You are a strong operator who keeps day-to-day ticket handling on track, ensuring SLAs for response, resolution, and satisfaction are always met.
• You are data-driven, using performance insights to spot trends, balance workloads, and push for continuous improvement.
• You are process-minded, always looking for ways to streamline operations and create a smoother, more accurate patient experience.
• You are a natural problem solver and the go-to escalation point, working across teams to resolve patient-impacting issues quickly.
• You are goal-oriented, setting clear KPIs and cycle targets that keep your team focused and motivated.
• You are a supportive leader who removes blockers so your team can perform at their best.
• You are accountable for driving key metrics within your scope and making sure the team delivers impact.
• You are a people leader, confident in hiring, onboarding, coaching, and managing performance with fairness and care.

Skills & Experience

About you (Who Are We Looking For)

• Strong Leader: You have at least one year of full-time leadership experience, in a startup, international or tech company (three years in BPO). You lead with empathy and kindness, but you hold your team accountable to performance standards and provide direct, clear feedback
• Preferably, you have experience with online/remote/virtual work, however not essential.
• Tech-savvy: You have a working knowledge of Google Suite (Gmail, Calendar, Drive, Docs, Sheets, Forms, Slides), Slack, Notion, and other productivity and project management tools/apps. You are comfortable with various commonplace technologies and are able to adapt to new systems quickly.
• Strong communicator: You have excellent command of the English language, both spoken and written. You are an attentive listener and are able to interact with stakeholders in a concise and effective manner.
• People person: You are great at motivating others to achieve a common goal, you can work with a range of different personality types and bring out the best in those around you
• Exceptional problem-solver: You are not fazed by complex problems and are able to offer creative solutions. You think critically and troubleshoot effectively, whether it's resolving technical or operational issues. You know when to ask questions to clarify expectations.
• Trustworthy: You embody trust and dependability. You know how to treat sensitive information with confidentiality on a daily basis.
• Proactive: You have a charismatic 'can do' attitude. You require minimal supervision and take ownership in your work. You are motivated by impact and motivated by wanting to help others. You go the extra mile to make life easier for your assigned Leadership Team members.
• Learner's Mindset: You foster a strong desire to learn and develop. You can easily adapt in a fast paced environment and consider every new experience as an opportunity to learn. You strive for excellence and constantly improve your abilities.
• You are willing to work full-time (40 hours/week) in a hybrid set up during either APAC customer hours
• UK Business Hours: 1:00PM - 3:00AM Manila Time
• You are located near or within Metro Manila, Philippines
• You have a suitable work-from-home space (work desk, comfortable chair, proper lighting, quiet environment)
• You have stable internet connection at home: 30 Mbps minimum

Why you should join Euc

• Our teams are incredibly passionate - Our talent bar is high and our work ethic is strong. You'll get to stretch yourself everyday and work amongst people who care deeply about our patients. You'll be given autonomy to tackle interesting problems and receive regular feedback from a supportive team
• We'll have your back when you need us the most - You'll be able to lean on a range of leave offerings to support you when needed from Day 1, this includes: sick, maternal/paternal, compassionate, and vacation leave. Personal health days leave and budget to encourage you to take care of your well-being. A reliable health insurance provider accredited by major hospitals, clinics, and diagnostic centers nationwide, plus coverage of up to two dependents. Standard employer share for statutory benefits (SSS, PhilHealth, and HDMF), and 13th month pay. Also, transportation allowance to support your expenses when reporting to our Makati office.
• We will invest in your career - You'll get access to an annual professional development budget and additional leave credits, mentors and buddies to ensure that you have the support you need to level up. You can expect regular performance and pay reviews as your career grows.
• We move at incredible speed - You'll work with team mates who build in the open by sharing their work freely, this helps us learn and iterate quickly so we can deliver high quality outcomes faster than our competitors. You'll **spend a lot of time outside of your comfort zone learning and iterating frequently, we wouldn't have it any other way

At Eucalyptus, we value individuals from all backgrounds, experiences, and perspectives, and we embrace the unique qualities each person brings. When you apply, please let us know of any reasonable adjustments you may need during the interview process.

Job Description:

Primary Roles Responsibilities:

· Answer Incoming calls and also make outbound calls.

· Ensure that right patient is identified before disclosing information

· Listen to Customer queries and resolve and provide solutions, if unable to resolve, have the same escalated to the supervisors If Insurance query, respond appropriately, also obtain relevant missing info from the patient so that claim can be processed

· Understand and handle disputes

· Detailed Documentation

· Efficient Call Handling Time

· Potential Follow Up Methods Payment in Full and Partial Payment discussions

· Understand difference between dispute & objection

· Effective rate of speech - good communication & neutral accent Obtain Insurance details from patients

· Obtain Additional Info - Referral Information / PCP information, etc.

· Call for accidental Information like DOA Demographic details/ Mismatch in Name and DOB

· Update patient about their out-of-pocket expenses

· Obtain WC details, Injury Date COB Update/ABN/AOB pending

· Appointment Scheduling, Appointment Cancelation, Appointment Reminder

Secondary Roles Responsibilities:

· Maintain professional decorum and punctuality

· Plan leaves well in advance

· Ensure good interpersonal relation is maintained while coordinating

Compliance

· Ensure privacy and security in the operation and in the operation area that includes work from office and home.

· Ensure you have acknowledged all the Organizational policies as per HR Procedure

· Ensure you are attending the Compliance awareness and refresher sessions & other security training programs as per L&D Procedure

· Ensure you are aware of agreed SLA of the projects you are working.

· Follow all the Information security guidelines

· Report any Security & Privacy incidents to your reporting manager/ HR/Compliance Team/CISO

· Ensure Confidentiality, Integrity & Availability of Data/information you handle

· Adhere to the NDA & confidentiality Agreement

· Adhere to the Micro Company's CISO's roles & responsibilities if you are a Micro Company Compliance SPOC

Skills:

• Must have 1 year Healthcare work experience
• Experience in Medical Billing
• Experience in RCM (clinical or non-clinical)
• Patient Provider Services

Location: Ortigas, Pasig City (at the back of SM Mega Mall)

100% onsite

Night shift