The Truth Behind Healthcare Account | What They Don't Tell You | BPO Account Series | Metacom
Summary
TLDRThis video is an informative guide for newcomers or career shifters entering healthcare accounts in the BPO industry. It covers what a healthcare account is, the application and training processes, typical work tasks, and common challenges. The video highlights that no medical background is required, although it can be advantageous. Training spans three months, including English skills and healthcare systems. The video also discusses the benefits and drawbacks of healthcare accounts, including salaries, stability, and the complexities of handling claims. Viewers are encouraged to apply for available roles at Medacom.
Takeaways
- 🔍 A healthcare account in the BPO industry handles administrative and operational tasks for healthcare organizations, such as claims processing, appointment scheduling, and customer support.
- 📞 Healthcare account agents assist healthcare insurance members or providers with inquiries about medical benefits or claims.
- 💡 You don’t need a medical background to work in a healthcare account; fresh graduates or those from different employment backgrounds are also welcome.
- ⌨️ Applicants must pass several tests, including typing speed (usually 36-40 words per minute) and customer service assessments.
- 🎓 The training for healthcare accounts lasts around three months, with a focus on communication skills, benefits, and claims processing.
- 📝 During training, agents learn to process claims, handle customer concerns, and analyze claim denials.
- 👩⚕️ Agents deal with both members and medical providers, often checking insurance coverage or clarifying the status of claims.
- 📑 Healthcare account agents need strong attention to detail, especially when reviewing denied claims or handling complex cases.
- 💰 The salary for healthcare account agents is competitive, starting at around 21,000 pesos, with incentives and allowances potentially increasing it to 27,000 pesos or more.
- 🔗 Despite some challenges, such as handling complex claims and blurry documents, healthcare accounts are considered stable and offer career growth opportunities.
Q & A
What is a healthcare account in the BPO industry?
-A healthcare account in the BPO industry refers to the management of administrative and operational processes related to healthcare organizations. This can include services like claims processing, appointment scheduling, medical transcription, healthcare analytics, and customer support.
Do you need a medical background to work in a healthcare account?
-No, a medical background is not required to work in a healthcare account. While a nursing or medical-related course may be an advantage, people with different employment backgrounds, including fresh graduates and undergraduates, can apply as long as they meet the minimum requirements and pass the recruitment process.
What types of tests and assessments are involved in the application process for a healthcare account?
-The application process for a healthcare account includes several tests and assessments, such as a typing test (requiring around 36-40 words per minute) and a customer service assessment to evaluate your ability to handle customer concerns.
What does the training process for a healthcare account involve?
-The training process for a healthcare account typically lasts three months. It includes English communication skills training, benefits and claims training, and practical call-handling training. The first month covers English 101 and benefits training, while the remaining two months focus on claims training and handling calls.
What is the role of a customer service representative in a healthcare account?
-A customer service representative in a healthcare account assists healthcare insurance members or providers with their inquiries, including verifying benefits, processing claims, and clarifying reasons for claim denials. They handle these interactions primarily through phone calls.
What is the difference between member and provider lines in healthcare accounts?
-The member line involves assisting individuals (members) with inquiries about their health insurance, such as benefits and claims, while the provider line involves helping healthcare service providers (e.g., doctors or hospitals) with claim inquiries and service coverage.
How do agents handle claim denials in a healthcare account?
-When a claim is denied, agents review the reason for the denial by analyzing the patient’s plan, relevant documents, and the claim forms. They explain the denial to the member or provider and may guide them on resubmitting or appealing the claim if necessary.
What challenges do healthcare account agents commonly face?
-Common challenges include handling complex or repeatedly denied claims, managing multiple resources and tools for different medical plans, dealing with blurry scanned documents, and coordinating benefits when a member has multiple health insurance plans.
What are the advantages of working in a healthcare account?
-Advantages of working in a healthcare account include stable employment, competitive salaries (with a base of at least PHP 21,000 and potential earnings of up to PHP 27,000 or more), and additional benefits such as transportation, rice, and clothing allowances.
How can candidates improve their chances of passing the interview and assessments for a healthcare account role?
-Candidates can improve their chances by practicing their typing skills on online platforms and preparing for customer service assessments. Enhancing their grammar and communication skills can also be beneficial, and resources like interview guides and tips can help with the preparation process.
Outlines
👩⚕️ Introduction to Healthcare Accounts in the BPO Industry
The video opens by addressing newcomers or career shifters entering healthcare accounts in the BPO industry. The speaker introduces the concept of healthcare accounts, outlining the administrative and operational tasks involved, such as claims processing, appointment scheduling, and customer service. The healthcare account supports both members (patients) and providers (doctors, clinics) regarding medical claims and benefits inquiries. The speaker also dispels the myth that only those with a medical background can apply for these roles, noting that the hiring process is open to a variety of educational and professional backgrounds.
📝 Overview of the Application Process for Healthcare Accounts
The second paragraph explains the recruitment process for healthcare accounts, detailing the tests and assessments that candidates must pass, such as typing speed and customer service skills. The speaker reassures viewers that a medical background is not required but can be an advantage. The process includes typing tests, customer service assessments, grammar checks, and communication skills evaluations, along with interviews. Upon passing these, candidates are required to complete job requirements like medical exams before beginning their training.
📚 Healthcare Account Training Structure
The third section focuses on the training process for healthcare account agents. Training lasts about three months, split into English communication skills training, benefits training, and claims training. Agents are prepared to handle conversations with both members and providers, learning how to explain claims denials, process claims, and manage medical benefits. The speaker advises trainees to take notes and emphasizes the importance of understanding various health plans, claims forms, and insurance processes.
Mindmap
Keywords
💡Healthcare Account
💡BPO Industry
💡Claims Processing
💡Members
💡Providers
💡Training Process
💡Benefits Training
💡Claims Denial
💡Escalation
💡Coordination of Benefits
Highlights
Introduction to healthcare accounts in the BPO industry and how they cover a wide range of services such as claims processing, appointment scheduling, and medical transcription.
Definition of a healthcare account in the BPO context, focusing on assisting healthcare insurance members or providers with benefit or medical claim inquiries.
Healthcare accounts in the BPO industry are open to people without medical backgrounds, including fresh graduates or career shifters.
The application process involves typing tests, customer service assessments, communication skills assessments, and interviews.
Training for healthcare accounts is divided into two main parts: benefits and claims training, followed by system training, which typically lasts for three months.
The first week of training focuses on English communication skills, while the remaining weeks cover benefits training and claims handling.
During training, agents are taught how to fill out claim forms, analyze claim denials, and communicate effectively with healthcare providers and members.
A typical workday involves assisting customers via phone calls, which may include verifying health insurance benefits and claims.
Healthcare accounts support both member and provider lines, focusing on either verifying health services or explaining claim denials.
Common challenges in healthcare accounts include dealing with complicated claims, organizing multiple medical resources, and handling blurry scanned documents.
Agents may encounter coordination of benefits calls, where members are covered by two health plans, adding complexity to claim handling.
Healthcare agents must learn to manage increased average handling time (AHT) and improve efficiency by handling simpler calls faster.
A key advantage of working in a healthcare account is the relatively higher salary, with the basic monthly salary starting at 21,000 pesos and additional incentives reaching up to 27,000 pesos or more.
Healthcare accounts in the BPO industry are considered one of the most stable, offering allowances such as transportation, rice, and clothing allowances.
The video concludes by emphasizing that healthcare accounts are career-shifter-friendly and highlights the benefits of joining a healthcare BPO.
Transcripts
if you're a newbie or a career shifter
in a healthcare account in the bo
industry and you're still clueless about
how it works then this is for you
because for today's video we'll be
talking about what it's like working in
a healthare
account until the end of this
one to prep yourself in handling a
healthcare account in the BPO industry
openings right now here at
metacom L description box below once
again this is
Jamie and before we fully get into the
video let me give you an overview about
the things that we are going to talk
about first off is of course we'll
Define what is a healthare account
followed by the application
process ning
graduate this training
process what
about agent under this account and most
especially
concerns agents under a healthcare
account and lastly advantages and
disadvantages in this account without
further Ado let's get the video
rolling so what is a healthcare account
in the BPO context well this account
refers to the management of various
administrative and operational processes
that's related to healthcare
organizations so to further explain a
healthcare account in the boo industry
it can cover a wide range of
services
and RN and
pH
industry claims processing appointment
scheduling medical transcription
healthare analytics and customer
support customer service Representatives
while to add on that a healthcare
account in the boo industry is a
customer service program where an agent
assist a healthcare insurance member or
provider where their benefit or medical
claims inquires so peeps when we say
members
ilze health insurance to visit their
doctor get diagnosis or treatment for an
illness or condition of course included
insurance or health plan and when we say
providers they are the people who are
giving Medical Services like doctors
private clinics or hospitals or anyone
who renders a medical service to Health
Care members now let's talk about your
application process and of
course under a healthare account well
you might think that this account is for
only those aspirants with a medical
background well that is a myth to bust
although a previews let's say nursing or
medical related course is an advantage
this account also hires people with
different employment background MAA
undergraduate or fresh graduate command
so long as you meet the minimum
requirement and pass the recruitment
process and work under this field well
just like any other job or BP accounts
in healthcare
account several test and assessments
like typing test and customer service
assessment so for typing test they might
require a certain speed that's ideal to
handle a healthare account because it
doesn't have to be too fast usually 36
to 40 words per minute okay but if
you're not still that confident typing
skills well you can still definitely
enhance and practice that by visiting
typing test websites on your search
engines while for customer service test
expect questions that will Gat about
ility to handle customer concerns or any
particular concern of course now related
to medical field and please keep in mind
that the recruitment or application
process may also involve a grammar or
communication skills assessment
and two interviews may happen the
initial and final and once you pass your
final interview you might sign a
contract within the day and you will be
asked to finish or complete the job
requirements like medical exams prior to
your training day if you're still
worried or not yet that confident when
it comes to interview or let's say your
grammar and communication skills because
we prepared a playlist for you here
about the job interview guides and tips
when it comes to your application what
to expect during your training days in a
healthcare account so whether you'll
assist members or providers in this
account the training usually has two
parts and these are benefits and claims
training and
also
heal
system normally training lasts for 3
months yes it's quite long as compared
to other accounts training
duration you'll have more time to grasp
and understand everything so to break
down training process for the 3 months
well the first week is alloted for your
English 101 training this is a
refresher confident when it comes to
your English communication skills
then it will be followed by benefits
training which is usually around 3 weeks
so one month and then the remaining two
months usually alled claims training and
actual taking of calls although yes
you'll be encouraged to sound natural
when taking calls
during orical providers a clear and
correct
information our conversation also during
training you'll also learn some tips on
how to set proper expectations and how
to ask proving questions to medical
service providers or members when it is
necessary well
onep is that during your training
duration make sure to take notes because
it will help you familiarize yourself
with the types of
plans communication skills Healthcare
agents well most likely the trainers in
a healthcare account will teach you how
a claim form should be filled out and
they will teach you how to analyze a
claims
denial expain members or medical
providers and
chenging well at some point you might
find a training overwhelming but you
don't have to worry because
secret notes Focus on your research
skills and the rest you will definitely
learn that and acquire that dependent
learning curve so how does a typical
work day look like as a healthcare
account customer service
representative customer service
Representatives your main goal is to
assist or cater the needs of your
clients or customers either medical
provider or members themselves so what
you have to do is to assist them via
phone call and most
likely with them or conversation with
with them with a small talk because it
can definitely break the ice and from
the very
beginning or customer or medical
provider even over the
phone smooth conversation all throughout
the call healthare
accounts can support a wide range of
services and you're likely to support
these two main lines of
business is the memb line Second is the
provider line as an agent in a
healthcare account there are times that
you only need to check the eligibility
of the member or covered health
insurance but most of the time receive
is about benefits and claims calls well
it's a benefit call if a member or
medical service provider inquires for
medical services coverage like for
example they will likely ask Health
Services like checkups or diagnosis
treatments and
even and then then it's a claim call n
man if they just want to verify the
status of their claims or they just want
to clarify why the service done was
denied
ands that agents are not the ones who
decide whether a claim is approved or
not well most of the time claims are
already processed by the
time members or medical providers and
the job of the agent is to review why
the claim was denied for a particular
reason so that a member or a medical
provider will know if they can still
resubmit a claim or appeal for it in
short agents will analyze the denial
based on the patient plan relevant
documents of the service and scan claim
forms thus attention to details is a
must
met com section below usual as an agent
under this account concerns
usually while talking to your customers
now let's discuss the usual concerns
that are being encountered by Healthcare
account agents well
generally healthare accountb and career
shifter friendly but just like any other
accounts pros and cons and these are
some of the challenges that you need to
get ready for well complicated old
claims well these are the types of
claims that keep coming back because
it's being denied for some reason is
because pending prior approval some
services or because of incomplete claim
forms update up until now sometimes
these types of claim can reach a
level members or providers and that
means
agent deeper or browse through the
claims
history customers so
asid or medical providers that's why an
agent needs to learn when to file an
escalation ticket or when to seek a
higher support so that problematic old
Claims can still be processed correctly
regardless whether it's approved or
still approve next is multiple resources
well types of plans Health Care laws and
the insurance Network are also needed to
be explored from time to
time separate links or tools for some
major benefits like Dental or drug
prescription it's a must for you to have
your own method or strategy to organize
this numerous medical resources so you
can access them easily and third is
blurry scan documents so when it comes
to claims forms are usually scanned
store and database of course I may
access agent these scan copies are okay
they still look like
photocopied
or better
yet very
CR medical providers next on our list is
coordination of benefits call well when
a member is covered by two health plans
for example a child is Health insured or
dependent both parents
medical expenses using his primary
Insurance secondary insurance and there
are certain rules that apply to
identify primary or secondary insurance
and but you don't have to worry because
the good news
is
of but it's okay to familiarize yourself
as well on how it
works Ty of call while you are on your
ship while these challenges can also
result in increased average handling
time or
ahd another concern but because the best
technique is to make up by handling the
easier calls or concerns faster and last
but not the
least and disadvantages as well under a
healthare account
well this Advantage
Isel career shifter or
advantages under a health
account service why basic monthly salary
usually agents under this account is at
least 21,000 pesos and take
note there are other B companies offer
higher salary or monthly basic salary if
you're already an experienced agent
aside from that monthly incentives or
programs and also there are various
allowances like Transportation allowance
rice allowance clothing allowance
or on top of your monthly basic salary
your salary can reach to 27,000 and
above and aside from that Healthcare
account is also considered as one of the
most stable accounts in the boo industry
and that's it for this video and I hope
that it can help you get started with
your journey as a healthcare account
agent openings right now here at
medom link description box below and
fill out our online application form and
we'll be more than happy to assist you
with your application with us here at
Medicom also don't forget to like share
and subscribe to this channel thank you
so much once again and see you in our
next video
[Music]
bye
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