Junior Claims Officer

Golden Renal Care Holdings Inc.; Teresa; On-site; PHP 201,000 - 312,000; Full time

Job summary

Golden Renal Care Holdings Inc. is seeking a Junior PhilHealth Claims Officer to support preparation, submission, and monitoring of dialysis patient claims. You will organize documents, encode details in PhilHealth systems, and follow up on pending or denied claims to help the revenue cycle.

You should have a related degree and 1–2 years of billing experience, with strong MS Office skills and meticulous attention to detail. This role requires accuracy and good teamwork.

Qualifications

• Bachelor’s degree in Accounting, Business Administration, Nursing, or related healthcare field.
• 1–2 years of experience in claims processing or healthcare billing (PhilHealth experience preferred).
• Basic knowledge of PhilHealth rules, benefit packages, and claims procedures.
• Proficiency in MS Office and healthcare billing systems.

Responsibilities

• Collect and organize patient treatment logs, medical records, and supporting documents for PhilHealth claims.
• Encode claim details into the PhilHealth system accurately and promptly.
• Assist in preparing claim forms and attachments for submission.
• Track submitted claims and update records on claim status.
• Assist in following up with PhilHealth offices regarding pending or denied claims.
• Report discrepancies or issues to the Senior Claims Officer.
• Ensure claims comply with PhilHealth guidelines and dialysis-specific requirements.
• Maintain proper filing and secure handling of patient records and claim documents.
• Stay updated on PhilHealth circulars and benefit package changes.
• Work closely with the Billing and Accounts Receivable team to reconcile reimbursements with patient accounts.

Skills

Attention to detail

Communication skills

Organizational skills

PhilHealth knowledge

MS Office

Healthcare billing systems

Education

Bachelor's degree in Accounting, Business Administration, Nursing, or related healthcare field

Tools

MS Office

Healthcare billing systems

Job description

About the role

The Junior PhilHealth Claims Officer assists in the preparation, submission, and monitoring of PhilHealth claims for dialysis patients. This role supports the claims team by ensuring accurate documentation, compliance with PhilHealth requirements, and timely processing to contribute to the center's revenue cycle.

Key responsibilities

• Collect and organize patient treatment logs, medical records, and supporting documents for PhilHealth claims

• Encode claim details into the PhilHealth system accurately and promptly

• Assist in preparing claim forms and attachments for submission

• Track submitted claims and update records on claim status

• Assist in following up with PhilHealth offices regarding pending or denied claims

• Report discrepancies or issues to the Senior Claims Officer

• Ensure claims comply with PhilHealth guidelines and dialysis-specific requirements

• Maintain proper filing and secure handling of patient records and claim documents

• Stay updated on PhilHealth circulars and benefit package changes

• Work closely with the Billing and Accounts Receivable team to reconcile reimbursements with patient accounts

About you

• Bachelor's degree in Accounting, Business Administration, Nursing, or related healthcare field

• 1–2 years of experience in claims processing or healthcare billing (PhilHealth experience preferred)

• Basic knowledge of PhilHealth rules, benefit packages, and claims procedures

• Proficiency in MS Office and healthcare billing systems

• Strong attention to detail and organizational skills

• Good communication and interpersonal skills

• Ability to work under supervision and follow established procedures

• Integrity, confidentiality, and professionalism

• Time management and ability to meet deadlines