HMO Staff

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

Government Mandated Benefits

13th Month Pay, Paid Holidays

Insurance Health & Wellness

HMO

URGENT HIRING!

HMO Staff/Officer that facilitates all HMO approval for ER, In-Patient Department, and Out-Patient Department.

Principal Functions

• Provide exceptional service and care to patients
• Accommodate and respond to patient inquiries with health cards and company guarantee letter
• Process requests for consultation and procedures
• Coordinate with accredited HMOs and companies' approval of requested procedures, card verification and related requests
• Receive and check referral slips/Letter of Authorization and relevant documents of the patient, promptly process transactions, and endorse to immediate supervisor for review
• Endorse charge slips and pertinent supporting documents promptly to Credit and Collection
• Update HMO files of patients, record and store properly

Other related functions

• Performs other related tasks as assigned or delegated by the immediate superior.
• Coordinate with other departments and staff to facilitate proper endorsement of patients
• Communicate with physicians and other clinical staff to ensure that patient documentation has complete and accurate information
• Be updated with the latest HMO memorandum and circulars
• Complies to 5S, Internal quality and customer care standards, policies and procedures.
• Practices the CORE values of the company

Qualifications

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

Working Location

Nuvali North, West Nature Ave, Santo Domingo, City of Santa Rosa, Laguna, Philippines