HMO Patient Services & Approvals Specialist

Healthway Qualimed Hospital Santa Rosa; Laguna; On-site; PHP 246,000 - 357,000; Full time

Benefits offered by this job

HMO

13th Month Pay

Paid Holidays

Job summary

Healthway Qualimed Hospital Santa Rosa is urgently hiring an HMO Staff/Officer to facilitate all HMO approvals for ER, IPD, and OPD. You will coordinate with HMOs and company letters to process procedures, referrals, and authorization documents.

Responsibilities include updating HMO files, endorsing charge slips to the supervisor, and communicating with physicians to ensure accurate patient documentation. Knowledge of HMO industry is preferred.

Qualifications

• University degree in a relevant medical or allied course.
• Knowledge of the Health Maintenance Organization (HMO) industry.

Responsibilities

• Provide HMO approvals for ER, IPD, and OPD.
• Coordinate with HMOs and company letters for procedures.
• Process referrals, letters of authorization, and document verification.
• Update HMO files and endorse to supervisor.
• Communicate with physicians to ensure complete patient documentation.
• Stay updated with latest HMO memos/circulars.

Skills

Customer service

Communication with physicians

Education

University degree in a relevant medical or allied course

Job description

Healthway Qualimed Hospital Santa Rosa is urgently hiring an HMO Staff/Officer to facilitate all HMO approvals for ER, IPD, and OPD. You will coordinate with HMOs and company letters to process procedures, referrals, and authorization documents.

Responsibilities include updating HMO files, endorsing charge slips to the supervisor, and communicating with physicians to ensure accurate patient documentation. Knowledge of HMO industry is preferred.