Claims Associate Manager

Healthway QualiMed Hospital San Jose del Monte; San Jose del Monte; On-site; PHP 240,000 - 360,000; Full time

Job summary

Healthway QualiMed Hospital San Jose del Monte seeks a PhilHealth Claims Supervisor to oversee daily operations of the PhilHealth section and staff. You will ensure patients receive maximum coverage and timely filing of claims.

Responsibilities include reviewing submitted claims, monitoring status, and staying updated on PhilHealth memoranda and policy changes to ensure compliance with company procedures.

Responsibilities

• Supervise the day-to-day operations of the PhilHealth section and assigned staff.
• Ensure patients receive maximum coverage and benefits under PhilHealth.
• Facilitate timely and accurate filing of PhilHealth claims to minimize underpayments and denied claims.
• Review and validate claims submitted for PhilHealth reimbursement.
• Monitor claim status and ensure timely resolution of discrepancies and deficiencies.
• Stay updated on the latest PhilHealth memoranda, circulars, policies, and guidelines.
• Ensure compliance with company policies, procedures, and applicable regulations.
• Perform other related duties and responsibilities as assigned by the immediate superior.

Job description

• Supervise the day-to-day operations of the PhilHealth section and assigned staff.

• Ensure patients receive maximum coverage and benefits under PhilHealth.

• Facilitate timely and accurate filing of PhilHealth claims to minimize underpayments and denied claims.

• Review and validate claims submitted for PhilHealth reimbursement.

• Monitor claim status and ensure timely resolution of discrepancies and deficiencies.

• Stay updated on the latest PhilHealth memoranda, circulars, policies, and guidelines.

• Ensure compliance with company policies, procedures, and applicable regulations.

• Perform other related duties and responsibilities as assigned by the immediate superior.