Philhealth Assistant

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

ABOUT US

As a private, Level 3 hospital, Lourdes Hospital takes pride in its rich history and unwavering commitment to delivering Alagang May Puso, Tapat, at Abot-Kaya. For more than seven decades, we have stood as a Christ-centered community of healthcare professionals, devoted to providing compassionate care with integrity and ensuring that quality healthcare remains accessible to all.

Our mission is to promote holistic healing—nurturing the body, mind, and spirit of every patient—through heartfelt service that embodies excellence, faith, and compassion.

JOB SUMMARY

• Customer Service & Information - Responds to inquiries with accuracy and professionalism regarding PhilHealth policies, processes, documentation, and case rates.

• Patient Verification - Confirms eligibility and requirements for PhilHealth-covered inpatients and outpatients; validates membership, checks past availments, and ensures proper documentation.

• Intake & Coordination - Guides patients/families on forms, coordinates with medical staff, explains regulations, and prepares acknowledgment slips with case rates and ICD-10 codes.

• Claims Processing - Prepares, verifies, and submits PhilHealth claims (CF2, CF3, CF4), encodes data, attaches supporting documents, transmits e-claims, and ensures timely, complete submissions.

• Claims Reprocessing - Handles Return-to-Hospital (RTH) and denied claims by addressing deficiencies, refiling, and preparing reconsideration letters.

• Reporting & Monitoring - Generates weekly reports on denied/RTH claims, tracks cataract approvals, enrolls new dialysis patients, and maintains organized filing of paid claims.

EMPLOYEE BENEFITS

• 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

QUALIFICATIONS

• Bachelor's degree holder of any Business-related course

• At least 1-year relative experience