PHILHEALTH BILLING & COLLECTION MANAGER

LG Health Inc.; Pasig; On-site; PHP 600,000 - 1,200,000; Full time

Job summary

LG Health Inc. in Metro Manila seeks an experienced Billing Manager to lead PhilHealth and other claims processing, optimizing revenue cycles and maximizing reimbursements.

You will develop billing policies, oversee complex claims issues, mentor the billing team, and act as liaison with senior management and external regulators. The ideal candidate holds a bachelor's degree with several years in healthcare billing, plus leadership experience and strong communication skills to drive standards

Qualifications

• Bachelor's degree in a related field is required.
• 3–5 years in healthcare billing and claims management with supervisory experience.
• Experience with PhilHealth processing, guidelines, deductions, and appeals.

Responsibilities

• Process PhilHealth and other healthcare claims efficiently and compliantly.
• Optimize the revenue cycle and maximize reimbursements.
• Develop and implement billing policies and procedures.
• Oversee complex claims issues and mentor the billing team.
• Liaise with senior management and external regulatory bodies.

Skills

Leadership

Analytics

Problem-solving

Communication

Attention to detail

Project management

Education

Bachelor's degree

Master's degree or CPC/CPB

HIM/ICD-10 training

Tools

eClaims

HIS/PIS

BizBox

Job description

This position ensures the efficient and compliant processing of all PhilHealth and other healthcare claims, optimizing the revenue cycle and maximizing reimbursements for the organization. The Manager develops and implements billing policies and procedures, oversees complex claims issues, leads and mentors the billing team (including Billing and Claims Supervisors and Officers), and serves as a primary liaison with senior management and external regulatory bodies.

Education:

• Bachelor's degree required, preferably in Health Administration, Business Administration, Accounting, Finance, or a related field.
• A Master's degree or relevant professional certification (e.g., Certified Professional Coder - CPC, Certified Professional Biller - CPB) is highly preferred.
• Health Information Management Certification, Medical Records Certification, or ICD-10 Training.

Experience:

• Extensive experience (minimum 3-5 years) in healthcare billing and claims management, with at least 3 years in a supervisory or managerial role.
• Proven expertise in PhilHealth claims processing, guidelines, outright deductions, and appeals management.
• Strong track record of optimizing revenue cycles and improving collection rates in a healthcare setting.

Skills:

• Exceptional leadership, management, and team development skills.
• Strong analytical, problem-solving, and critical thinking abilities, particularly for complex claims issues.
• Expert proficiency in electronic claim filing systems (eClaims) and healthcare billing/information software (e.g., HIS, PIS, BizBox).
• In-depth knowledge of ICD-10 and RVS coding.
• Excellent communication (verbal, written, and presentation), negotiation, and interpersonal skills for internal and external stakeholders.
• High level of attention to detail and accuracy in all aspects of billing and claims.
• Strong organizational and project management skills.