Hospital Liaison Officer

Lift Off Consulting Inc; Cebu City; On-site; PHP 180,000 - 240,000; Full time

Benefits offered by this job

Health Insurance

Life Insurance

Job summary

Lift Off Consulting Inc. is hiring for an On-site Health Insurance & Wellness role in Cebu for fresh graduates with a bachelor’s degree in medical allied fields.

The position focuses on enhancing customer experience, utilization management, and claims processing within the Cebu area. The role requires field work at clinics/hospitals, with responsibilities including admission management, authorization processing, discharge coordination, and end-of-day reporting.

Qualifications

• Graduate of medical allied courses, preferably Nursing or Physical Therapy.
• Preferably with experience in the nHMO industry.
• Must be willing to do field work at clinics/hospitals around Cebu area.

Responsibilities

• Ensure efficient execution of first-class Customer Experience for the assigned provider.
• Closely monitors admissions in assigned/affiliated providers.
• Creates case and authorization in One System; updates discharge date within 24 hours.
• Visits admitted members to reorient benefit plan and requirements during admission, ensuring understanding.
• Assesses availment and issues Letter of Authorization according to billing and collection.
• Monitors members' confinement progress through the patient’s medical chart.
• Revisits the member when necessary.
• Assist member during discharge to ensure proper computation and collection of uncovered charges.
• Captures provider issues such as unpaid claims and hospital policy changes.
• Establish a good working relationship with affiliated providers.
• Reviews and analyzes admission cases; checks necessity of confinement/procedure.
• Reports LOS and cost of confinement.
• Coordinates complex/catastrophic cases to supervisor for proper management.
• Approves coverage up to ₱50,000; otherwise refers to authorized approver.
• End-of-day report of admissions and discharges.
• Updates endorsements to claims in OS for claims reference.

Skills

Customer Experience

Utilization Management

Report Generation

Education

Medical allied courses

Tools

One System

Job description

On-site - Cebu Fresh Graduate/Student Bachelor Full-time

Job Description

Insurance Health & Wellness

Health Insurance, Life Insurance

JOB SUMMARY:

The position is essentially responsible for effectively carrying out set strategies of the Customer Experience Division relevant to the confinement of valued members. It ensures customer satisfaction through effective rapport and proper utilization management.

DUTIES AND RESPONSIBILITIES:

1. CUSTOMER EXPERIENCE

• Always ensures efficient execution of the est-in-class Customer Experience for the assigned provider.
• Closely monitors admission/s in assigned/ affiliated providers
• Creates case and Authorization in One System; updates discharge date within 24hours
• Visits admitted member and reorients benefit plan and requirements during the admission, and ensures understanding through acknowledgement of the Visit Form
• Assesses availment and issues a Letter of Authorization according to billing/credit and collection
• Closely monitors members' confinement progress through the patient's medical chart
• Revisits the member whenever necessary.
• May assist the member during the discharge to ensure proper computation and collection of uncovered charges
• Captures provider issues such as unpaid claims, implementation of new hospital policies, threats of suspension,n,s etc.
• Establish a good working relationship/partnership among affiliated providers

2. UTILIZATION MANAGEMENT

• Reviews and analyzes cases of admission; checks the necessity of the confinement and/or procedure.
• Reviews and reports members' Length of Stay (LOS) and Cost of confinement
• Coordinates complex/ catastrophic cases to the superior or Medical Resource for proper management
• Approves coverage based on authority limit up to P50,000; otherwise, shall refer to the authorized approver

3. REPORT GENERATION

• End-of-day report of admissions and discharges
• Updates the \"endorsement to claims\" in OS for Claim's reference

QUALIFICATIONS:

• Graduate of any Medical allied courses,e preferably Nursing/ Physical Therapy
• Preferably with experience in the nHMO industry
• Must be willing to do field work at the assigned clinics/hospitals around the Cebu area