Clinical Administrator: Pharmacy Claims & Care Coordination

Genfinity; Makati; On-site; PHP 360,000 - 480,000; Full time

Job summary

Genfinity in Makati is seeking a Clinical Administrator who will support clinical operations by validating case information and maintaining audit-ready documentation. You will coordinate outreach with prescriber offices and facilitate communications between prescribers and Clinical Pharmacists to ensure timely case resolution.

The role requires at least 1 year of U.S. healthcare experience, a Bachelor's degree, and proficiency with MS Office and MS Teams.

Qualifications

• Bachelor's degree required.
• At least 1 year U.S. healthcare experience.
• Proficiency with Microsoft Office tools and data-entry systems.
• Ability to conduct outbound calls and effectively communicate with provider offices.
• Comfortable with electronic communication (email/MS Teams).
• Familiarity with case management, documentation and compliance standards.
• Experience in PBM, managed care, healthcare, or workers' compensation is an advantage.
• Strong attention to detail and accuracy in case processing.
• Capable of managing multiple priorities and meeting deadlines.
• Ability to work independently and exercise sound judgment.
• Amenable to work on shifting schedule during U.S. business hours.
• Will ing to work onsite at the Makati Office.

Responsibilities

• Receives and acts on system-generated alerts and workflow triggers.
• Reviews member, medication, and case information for accuracy and completeness.
• Maintains detailed and audit-ready case documentation.
• Conducts follow-ups with prescribers via calls, fax, and email.
• Prepares and distributes required clinical and administrative documents.
• Coordinates communication between prescribers and pharmacists.
• Monitors pending cases and follows up on outstanding requests.
• Collaborates with internal stakeholders to ensure timely case progression.

Skills

Communication

Detail oriented

Multitasking

Independent worker

Time management

Education

Bachelor's degree

Tools

MS Office

MS Teams

Data-entry systems

Job description

Genfinity in Makati is seeking a Clinical Administrator who will support clinical operations by validating case information and maintaining audit-ready documentation. You will coordinate outreach with prescriber offices and facilitate communications between prescribers and Clinical Pharmacists to ensure timely case resolution.

The role requires at least 1 year of U.S. healthcare experience, a Bachelor's degree, and proficiency with MS Office and MS Teams.