PhilHealth Claims Processing Analyst

Stfrancis; Hinoba-an; On-site; PHP 201,000 - 290,000; Full time

Job summary

Stfrancis is seeking a PhilHealth Claims Processing Assistant to join our healthcare administration team in the Renal Clinic network in the Philippines. You will manage claims processing, verify completeness, analyze variances, and ensure compliance with PhilHealth policies.

You will collaborate with the Accounts Receivable Analyst and Team Lead to monitor claims, update reports, and stay informed about PhilHealth updates. Strong detail orientation and MS Office proficiency are essential.

Qualifications

• Bachelor's degree in Accounting, Business Administration, Finance, or a related field.
• Proficiency in Microsoft Office applications (Word, Excel, PowerPoint).
• Familiarity with hospital billing software and electronic claims systems.
• Strong administrative abilities with excellent organizational skills.
• High degree of accuracy and attention to detail in handling documents and data.
• Knowledge of PhilHealth policies and procedures preferred.
• Effective communication and interpersonal skills; ability to work independently and in a team.

Responsibilities

• Schedule and receive PhilHealth claims and related documents from Renal Clinic branches.
• Review documents for completeness and accuracy, analyzing variances per PhilHealth policies.
• Determine patient benefit coverage and ensure utilization does not exceed available benefits.
• Verify that the number of claims submitted aligns with transactions reported in financial reports.
• Collaborate with the Accounts Receivable Analyst and Team Lead to ensure quality monitoring and timely submission.
• Update monitoring reports and maintain files necessary for claims filing and other administrative tasks.
• Stay informed about updates and circulars related to hemodialysis by checking PhilHealth website.

Skills

Attention to detail

Administrative skills

Communication skills

Team collaboration

Education

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

Tools

Microsoft Office

Hospital billing software

Job description

Stfrancis is seeking a PhilHealth Claims Processing Assistant to join our healthcare administration team in the Renal Clinic network in the Philippines. You will manage claims processing, verify completeness, analyze variances, and ensure compliance with PhilHealth policies.

You will collaborate with the Accounts Receivable Analyst and Team Lead to monitor claims, update reports, and stay informed about PhilHealth updates. Strong detail orientation and MS Office proficiency are essential.