Clinical Operations Associate – Pharmacy & Claims

Genfinity Philippines, Inc.; Makati; On-site; PHP 350,000 - 700,000; Full time

Job summary

Genfinity Philippines, Inc. in Makati is seeking a Clinical Administrator to support clinical operations, review case information, and maintain audit-ready documentation. You will coordinate outreach with prescribers and clinical pharmacists to promote timely case resolution.

The role requires at least 1 year of U.S. healthcare experience, a Bachelor’s degree, and proficiency in MS Office and data-entry systems. Onsite work in Makati with U.S. business hours is expected.

Qualifications

• Bachelor’s degree required.
• At least 1 year U.S. healthcare experience.
• Proficiency with Microsoft Office and data-entry systems.
• Capable of outbound calls and effective provider office communication.
• 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.
• Able to manage multiple priorities and meet deadlines.
• Willing to work onsite in Makati and support U.S. business hours.

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

Outbound calls

Provider communication

Data entry

MS Teams

Attention to detail

Multitasking

Independent work

Education

Bachelor’s degree

Tools

Microsoft Office

Data-entry systems

MS Teams

Job description

Genfinity Philippines, Inc. in Makati is seeking a Clinical Administrator to support clinical operations, review case information, and maintain audit-ready documentation. You will coordinate outreach with prescribers and clinical pharmacists to promote timely case resolution.

The role requires at least 1 year of U.S. healthcare experience, a Bachelor’s degree, and proficiency in MS Office and data-entry systems. Onsite work in Makati with U.S. business hours is expected.