Senior Recovery Resolution Specialist | Lipa | USRN with active license for Php50,000/monthly! in Lipa, Calabarzon, PH at TTEC

Date Posted: 2/7/2018

Job Snapshot

Job Description

At TeleTech, Customers are the life blood of our business. Understanding the importance of good customer service is essential for creating new customers, keeping loyal customers, and developing referrals for future customers.  We strive to stay connected with our customers at all touch points, and to value their feedback in return. Without this ongoing connection, our business would fail. 


Our client is an international company that operates in about 30 countries around the world offering various products and services to assist in weight loss and maintenance.
Your role as a Senior Recovery Resolution Specialist is to ensure that the organization is meeting the customer’s requirements on a day to day basis. You are the Customer Advocate who will take the lead in providing the best possible customer service experience while keeping the company’s business needs in perspective.

  • Investigates, reviews, and provides clinical and/or coding expertise in the application of medical and reimbursement policies within the claim adjudication process through file review.  This could include Medical Director/physician consultations, interpretation of state and federal mandates, applicable benefit language, medical and reimbursement policies and consideration of relevant clinical information.
  • Performs clinical coverage review of post-service, pre-payment claims, which requires interpretation of state and federal mandates, applicable benefit language, medical & reimbursement policies, coding requirements and consideration of relevant clinical information on claims with over billing patterns.
  • Performs clinical coding review to ensure accuracy of medical coding and utilizes clinical expertise and judgment to determine correct coding & billing.
  • Identifies over billing patterns and trends, waste and error, and recommends providers to be flagged for review.
  • Maintains and manages daily case review assignments, with a high emphasis on quality.
  • Provides clinical support and expertise to the other investigative and analytical areas.
  • Participates in provider/client/network meetings, which may include provider education through written communication.
  • Participates in training of new staff, and serves as a clinical resource to other areas within the clinical investigative team.

  • Knowledge of principles and processes for providing good customer service.  This includes customer needs assessment and meeting quality standards for service.
  • Active Listening & Problem Solving Skills - giving full attention to what the customer is saying, taking time to understand the points being made, asking questions as appropriate, and not interrupting at inappropriate times.
  • Excellent English Communication & Interaction Skills — conversant in English and can convey information effectively.
  • Service Orientation — Proactively looks for ways to help people; Ability to be polite, have confidence, and use diplomacy in difficult situations;
  • Able to set priories and multi‐task
  • Detail-oriented and customer-focused.

  • Bachelor’s degree
  • 2 years of RN, LPN current experience with active US license
  • 2 year of CPT/HCPCS/ICD-9 coding experience with a thorough knowledge of health insurance business, including knowledge of industry terminology, and regulatory guidelines


•        Competitive compensation package starting off at Php40,000/month

•        Medical and dental coverage plus life insurance options

•        Pharmacy, cellphone, transportation & rice benefits await those that qualify

•        TeleTech offers opportunities for career advancement, personal development and experiences meant to enhance the quality of your professional life

•        Immerse in personal development programs and continued skills enhancement through online and proprietary  TeleTech training curriculums

•        Engage with your colleagues and build friendships through exciting promotions, events and activities

  • Email.
  • SMS.  Text 0919.871.4455 and request for a phone interview
  • Online. Apply at http :// via computer or mobile phone
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