The Care Advisor is a multi-skilled role responsible for end-to-end case management across multiple service lines, including Customer Care, Home Nursing, Voice of Customer (VOC), Second Medical Opinion (SMO), complaints handling, and email correspondence.
The role requires high adaptability, strong clinical/operational knowledge, and excellent communication skills to manage diverse case types while ensuring timely resolution, high-quality service delivery, and customer satisfaction.
Main Tasks
- Manage and correspond to emails of members, providers, payers and clients ensuring timely service delivery aligned with patient needs.
- Handle Complaints, Home Nursing, Second Medical Opinion cases end-to-end, including document review, coordination with medical experts, and timely delivery of outcomes.
- Capture, manage, and resolve customer feedback and escalations across multiple channels, ensuring professionalism and timely resolution.
- Take full ownership of complex, sensitive, and escalated cases, ensuring effective investigation, resolution, and follow-up.
- Communicate clearly and professionally with members, providers, and stakeholders, ensuring accurate information across all channels.
- Ensure adherence to medical protocols, company policies, TATs, data protection, and quality standards across all case types.
- Maintain accurate case records and prepare structured reports, dashboards, and insights to support decision-making and audits.
- Analyze customer data, feedback, and operational trends to identify root causes and implement service and process improvements.
- Coordinate with internal and external stakeholders (claims, medical, providers, network) to ensure seamless service delivery and alignment.
- Manage high volumes of cases, prioritize effectively, meet deadlines, and maintain performance under pressure.
- Demonstrate empathy and professionalism, ensuring a high-quality customer experience and working to reduce recurring complaints.
- Exhibit accountability, integrity, and flexibility; support audits and quality initiatives and provide guidance/mentorship to junior team members.
Job Requirments
- * Bachelors Degree ; Medical background preferred.
- 2+ years experience in a Call Centre/ Customer Service environment, TPA Hospitals or Medical Centers exposure a plus.
- Strong communication skills in English (additional languages are an advantage)
- Good understanding of customer service principles and telephone etiquette
- Physically fit to carry out duties.
- Legally permitted to work in the country of operations.
- Fluency in MS Office (Excel, Word, Outlook, PowerPoint) and general internet navigation and research skills.
