HEALTHCARE BENEFIT SECTION HEAD

SPC Medical Centre; San Pablo; On-site; PHP 750,000 - 1,100,000; Full time

Job summary

SPC Medical Centre in the Philippines is seeking a Healthcare Benefits Manager to oversee PhilHealth claims, accreditation, and compliance. You will supervise the Healthcare Benefit team and ensure timely processing and verification of benefits, while monitoring denials and coordinating with PhilHealth and internal departments.

The role requires a Bachelor’s degree in healthcare administration or related field, at least 5 years in healthcare benefits, and 2 years in a supervisory capacity.

Qualifications

• Bachelor’s degree in healthcare administration or related field.
• At least 5 years of healthcare benefits experience.
• 2 years in supervisory/managerial role.

Responsibilities

• Oversee PhilHealth claims, accreditation, and compliance.
• Supervise the Healthcare Benefit team.
• Ensure timely claims processing and benefit verification.
• Monitor claim denials.
• Coordinate with PhilHealth and internal departments.
• Prepare reports and ensure compliance with applicable regulations and policies.

Skills

Leadership

Analytical skills

PhilHealth regulations

Claims processing

Coding

Billing

Reimbursement

Education

Bachelor’s Degree in Healthcare Administration, Business Administration, Hospital Management, or related field

Job description

Responsibilities:

• Oversee PhilHealth claims, accreditation, and compliance
• Supervise the Healthcare Benefit team
• Ensure timely claims processing and benefit verification
• Monitor claim denials
• Coordinate with PhilHealth and internal departments
• Prepare reports and ensure compliance with applicable regulations and policies.

Requirements:

• Bachelor’s Degree in Healthcare Administration, Business Administration, Hospital Management, or related field
• At least 5 years of healthcare benefits experience, including 2 years in a supervisory/managerial role
• Strong knowledge of PhilHealth regulations, claims processing, accreditation, coding, billing, and reimbursement; excellent leadership and analytical skills.