Hospital Claims & Patient Services Specialist

Our Lady of Lourdes Hospital; Manila; On-site; PHP 279,000 - 469,000; Full time

Benefits offered by this job

Life insurance coverage

Hospitalization benefits

Company leaves

Birthday leave

Employee discounts

Opportunities for promotion

Pay raise

Educational Assistance Program

Company events

Company Christmas gift

Discounted lunch

Free vaccinations

Free uniform

Free parking

Job summary

Lourdes Hospital in Manila is seeking a dedicated PhilHealth Claims Associate to handle inquiries, verify eligibility, guide patients on forms, and coordinate with medical staff for accurate case rates and ICD-10 codes.

You will prepare and submit PhilHealth claims (CF2, CF3, CF4), reprocess denied claims, and generate weekly reports while maintaining organized filing and contributing to compassionate patient service.

Qualifications

• Bachelor's degree in business-related field.
• At least 1 year of relative experience.

Responsibilities

• Responds to inquiries about PhilHealth policies, processes, and case rates.
• Verifies eligibility and requirements for PhilHealth inpatients/outpatients.
• Guides patients on forms and coordinates with staff; prepares acknowledgment slips with case rates and ICD-10 codes.
• Prepares, verifies, and submits PhilHealth claims (CF2, CF3, CF4) with supporting documents.
• Manages Return-to-Hospital (RTH) and denied claims; handles reconsideration letters.
• Generates weekly reports on denied/RTH claims and tracks cataract approvals.
• Maintains filing of paid claims and enrollment of new dialysis patients.

Education

Bachelor's degree in Business-related course

Job description

Lourdes Hospital in Manila is seeking a dedicated PhilHealth Claims Associate to handle inquiries, verify eligibility, guide patients on forms, and coordinate with medical staff for accurate case rates and ICD-10 codes.

You will prepare and submit PhilHealth claims (CF2, CF3, CF4), reprocess denied claims, and generate weekly reports while maintaining organized filing and contributing to compassionate patient service.