The Truth Behind Healthcare Account | What They Don't Tell You | BPO Account Series | Metacom

Summary

This 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.