Customer Service Manager

The Doctor will interact directly with customers seeking medical clarity on diagnoses, treatment plans, and procedures. The role involves providing unbiased medical guidance, helping customers understand their health conditions, and supporting them in making informed decisions. This position is focused on telephonic consultations and forms an essential part of the insurers customer support and service assurance model.

Key Responsibilities

1. Customer Interaction & Medical Guidance

• Handle inbound calls from customers requesting a second medical opinion.
• Review medical documents, reports, prescriptions, and diagnostic findings shared by customers.
• Provide clear, accurate, and ethical medical advice to help customers understand their diagnosis and treatment options.
• Offer guidance on alternative treatments, specialist referrals, and clinical pathways when relevant.
• Maintain empathy, respect, and professionalism in all customer interactions.

2. Clinical Assessment & Documentation

• Document all customer interactions, medical assessments, and advice provided in the system.
• Summarize key clinical observations and recommendations in easytounderstand language for customers.
• Identify cases that require escalation to senior medical experts or specialized departments.
• Ensure medical records are handled with utmost confidentiality and comply with data-protection guidelines.

3. Coordination & Collaboration

• Work closely with internal teams such as Claims, Customer Support, and Medical Underwriting for medical clarification.
• Provide inputs to claims teams when a customer’s medical understanding may impact claim decisions.
• Coordinate with network hospitals whenever additional clinical information is required.

4. Compliance & Quality Assurance

• Ensure all guidance is aligned with medical ethics and regulatory requirements.
• Follow the insurer’s protocols for customer communication and documentation.
• Participate in quality audits, training sessions, and continuous medical education modules.
• Adhere to SLAs for call handling, documentation accuracy, and customer satisfaction.

Contact HR Aakanksha : [phone removed]