Operations Support Associate

AIA (Web); Philippines; On-site; PHP 180,000 - 240,000; Full time

Job summary

MediCard Phils., Inc. is seeking an assertive Operations Support Assistant to handle reconciliation, refunds, reimbursements, and query resolution.

Reporting to the Operations Support Lead, you will support day-to-day operations to ensure smooth workflows and accurate processing in our HMO-based environment. This role emphasizes attention to detail, strong communication with providers and clients, and adherence to policies.

Qualifications

• Educational background: High school diploma or equivalent (Associate's degree in accounting, finance, or business-related field preferred).
• Experience: Previous experience in collections, accounts receivable, or a similar financial role is beneficial.
• Technical proficiency: Familiarity with accounting software, collections systems, and Microsoft Office.
• Communication skills: Strong verbal and written communication skills, particularly in handling sensitive and difficult conversations.
• Negotiation skills: Ability to negotiate payment arrangements and manage conflict resolution effectively.
• Attention to detail: High level of accuracy in maintaining financial records and documentation.

Responsibilities

• Reconciliation: Assist in reconciling financial transactions related to claims, payments, and refunds between internal records and external entities (e.g., healthcare providers, insurers). Identify discrepancies and work with relevant teams to resolve them promptly.
• Refund and reimbursement processing: Review and process requests for refunds and reimbursements in compliance with HMO policies, ensuring timely and accurate payments to clients, patients, or providers.
• Help desk support: Serve as a first point of contact for help desk inquiries related to operational issues, including billing discrepancies, claim statuses, and general queries from clients, providers, and internal staff.
• Query resolution: Investigate and resolve queries from both internal and external stakeholders, ensuring timely communication and effective problem-solving to maintain positive relationships and service quality.
• Documentation and reporting: Maintain accurate records of reconciliation activities, refund/reimbursement transactions, and help desk interactions. Assist in generating periodic reports for the Operations Support Lead on operational efficiency and issue resolution metrics.
• Process improvement: Identify areas of improvement in operational processes and assist in implementing solutions to enhance efficiency and service quality.
• Compliance: Ensure all tasks are completed in compliance with HMO policies, industry regulations, and relevant legal requirements.

Skills

Verbal and written communication

Accounts receivable

Collections

Negotiation

Attention to detail

Education

High school diploma or equivalent

Associate's degree in accounting/finance/business

Tools

Accounting software

Microsoft Office

Collections systems

Job description

MediCard Phils., Inc. is one of the country's leading HMO and the only HMO founded and run by Doctors. Since its inception, the concept of service-oriented total health care has been the molding ideal of MediCard. The competition is vast, and the benefits being offered by the competitors are tempting. However, MEDICard has taken the lead in providing innovative and productive ideas that cut down the cost of health maintenance without compromising its quality.

MediCard now boasts of more than half a million members and over 54,000 accredited doctors in over 1,000 hospitals and clinics nationwide. It also operates 16 MediCard free-standing clinics that provide services at par with those offered by hospitals minus the confinement.

MediCard is currently looking for assertive, dynamic and energetic individuals to fill up the following vacancy:

The Operations Support Assistant is responsible for handling key operational tasks related to reconciliation, refunds, reimbursements, and query resolution. This role is critical in ensuring smooth operational workflows, effective issue resolution, and maintaining strong relationships with both internal and external stakeholders. Reporting directly to the Operations Support Lead, the assistant helps manage the day-to-day support functions to optimize the overall efficiency of the operations department.

DUTIES & RESPONSIBILITIES

• Reconciliation: Assist in reconciling financial transactions related to claims, payments, and refunds between internal records and external entities (e.g., healthcare providers, insurers). Identify discrepancies and work with relevant teams to resolve them promptly.
• Refund and Reimbursement Processing: Review and process requests for refunds and reimbursements in compliance with HMO policies, ensuring timely and accurate payments to clients, patients, or providers.
• Help Desk Support: Serve as a first point of contact for help desk inquiries related to operational issues, including billing discrepancies, claim statuses, and general queries from clients, providers, and internal staff.
• Query Resolution: Investigate and resolve queries from both internal and external stakeholders, ensuring timely communication and effective problem-solving to maintain positive relationships and service quality.
• Documentation and Reporting: Maintain accurate records of reconciliation activities, refund/reimbursement transactions, and help desk interactions. Assist in generating periodic reports for the Operations Support Lead on operational efficiency and issue resolution metrics.
• Process Improvement: Identify areas of improvement in operational processes and assist in implementing solutions to enhance efficiency and service quality.
• Compliance: Ensure all tasks are completed in compliance with HMO policies, industry regulations, and relevant legal requirements.

MINIMUM QUALIFICATIONS

• Educational Background: High school diploma or equivalent (Associate's degree in accounting, finance, or business-related field preferred).
• Experience: Previous experience in collections, accounts receivable, or a similar financial role is beneficial.
• Technical Proficiency: Familiarity with accounting software, collections systems, and Microsoft Office.
• Communication Skills: Strong verbal and written communication skills, particularly in handling sensitive and difficult conversations.
• Negotiation Skills: Ability to negotiate payment arrangements and manage conflict resolution effectively.
• Attention to Detail: High level of accuracy in maintaining financial records and documentation.