Patient Care Specialist - HMO Account | Onsite - 2 Days Off

Asiatel Outsourcing; Eastern Manila District; On-site; PHP 279,000 - 424,000; Full time

Benefits offered by this job

Competitive basic salary

HMO coverage from Day 1

Rice and medical allowance

Transportation allowance

Paid leaves for work-life balance

Paid training from Day 1

Job summary

Asiatel Outsourcing is seeking a Patient Care HMO Officer to serve as the key liaison between members, healthcare providers, and the HMO in Ortigas Center, Pasig. You will ensure timely approvals and accurate case handling for both Inpatient and Outpatient services.

The role requires bilingual Filipino and English proficiency, solid medical terminology knowledge, and a service-oriented mindset. Fresh graduates with hospital internships are welcome, with training from Day 1 and solid growth

Qualifications

• Graduate of a four-year medical-related course (non-negotiable).
• Degree in Nursing, Medical Technology or Pharmacy or any medical-related course.
• Open to fresh graduates with hospital internship experience.
• Hospital internship exposure relevant to healthcare operations is an advantage.
• Knowledge of medical terminology (diseases, diagnostics, procedures).
• Proficient in Filipino and English (written and verbal).
• Willing to work onsite in Ortigas Center, Pasig.

Responsibilities

• Handle inbound calls and emails regarding benefits, coverage, provider access, and policies.
• Follow up on pending cases and coordinate with healthcare providers.
• Issue approvals for Inpatient and Outpatient availments within turnaround time.
• Provide professional and compassionate service as a frontline HMO representative.
• Maintain accurate member records and case documentation.
• Process and validate HMO requests, approvals, and benefit eligibility.

Skills

Bilingual English/Filipino

Medical terminology

Healthcare/BPO experience (adv)

Fresh grads with hospital internship

Education

Four-year medical-related degree

Nursing/Medical Technology/Pharmacy degree

Job description

WHY JOIN US?

Asiatel Outsourcing (ATOI) is the first Philippine-founded outsourcing company listed on the TSX Venture Exchange. As we continue to experience exceptional growth, we are looking for top-tier talent to join our dynamic team. We remain committed to fostering a culture of excellence, innovation, and career growth.

Our Healthcare Team is rapidly growing, and we are looking for dedicated professionals to join our Local HMO Account. This is a meaningful role where your work directly impacts patient access to quality healthcare.

If you are service-oriented, thrive in a fast-paced environment, and want a stable career with growth opportunities, this is the role for you.

Job Description

As a Patient Care HMO Officer, you will be the key link between members, healthcare providers, and the HMO. You will ensure timely approvals, accurate case handling, and exceptional member support for both Inpatient and Outpatient services.

Responsibilities

Member Support & Case Management

• Handle inbound calls and emails regarding benefits, coverage, provider access, and policies

• Follow up on pending cases and coordinate with healthcare providers

• Issue approvals for Inpatient and Outpatient availments within turnaround time

• Provide professional and compassionate service as a frontline HMO representative

Claims & Documentation

• Maintain accurate member records and case documentation

• Process and validate HMO requests, approvals, and benefit eligibility

• Assist in verifying medical cases, diagnostics, procedures, and claim admissibility

Quality & Compliance

• Use quality monitoring tools and data systems for performance tracking

• Prepare internal reports and recommend process improvements

Collaboration & Continuous Improvement

• Share insights with the Campaign Manager and leadership

• Coordinate with team leaders and support teams to resolve escalations

• Maintain professionalism, punctuality, and adherence to company standards

Qualifications

• Graduate of any four-year medical-related course (non-negotiable)

• Must hold a degree specifically in Nursing, Medical Technology or Pharmacy or any medical-related course

• Open to fresh graduates with hospital internship experience

• Hospital internship experience should include any hospital exposure relevant to healthcare operations is an advantage

• Knowledge of medical terminology (diseases, diagnostics, procedures)

• Basic familiarity with medical terminology for diseases, diagnostics, and procedures is required

• Experience in BPO healthcare or HMO accounts is an advantage

• Prior experience in HMO approvals or hospital admissions is a plus

• Proficient in Filipino and English (written and verbal)

• Willing to work onsite in Ortigas Center, Pasig

Benefits

• Competitive basic salary

• Paid training from Day 1

• HMO coverage from Day 1

• Rice and medical allowance

• Transportation allowance

• Performance-based annual salary increases

• Early regularization opportunity

• Paid leaves for work-life balance

• Fun company activities and supportive work environment.