PhilHealth Claims Specialist | ICD-10 & RUV Coding

Saint Francis Doctors' Hospital and Medical Center; Cagayan de Oro; On-site; PHP 240,000 - 360,000; Full time

Job summary

Saint Francis Doctors' Hospital and Medical Center in the Philippines seeks a skilled claims coder to manage PhilHealth processes and ensure accurate billing.

The role includes finalizing PhilHealth claims, coding procedures with ICD-10, itemizing charges, and preparing monthly reports, with strict adherence to hospital policies and submission timelines. Workplace is hospital-based in Cagayan de Oro.

Responsibilities

• Finalizing PhilHealth claims.
• Analyzes and codes surgical procedures using the Relative Unit Value (RUV) Scale.
• Processes and prepares patients' medical claims/benefits.
• Computes the deduction of the patient’s benefit claims, based on Unified Benefit Schedule by the PhilHealth, to be applied to the patient’s Statement of Account.
• Itemizes hospital charges such as medicines, x-ray/laboratory test, medical supplies, and others.
• Responsible for the coding of Final Diagnosis using International Classification of Disease Version 10 (ICD-10).
• Responsible for having the Form II signed by the Attending Physician.
• Responsible for having all claims signed by the Hospital Administrator & Asst. Hospital Administrator before submission to PHIC.
• Prepares Monthly Accomplishment Report on all claims submitted to PHIC.

Job description

Saint Francis Doctors' Hospital and Medical Center in the Philippines seeks a skilled claims coder to manage PhilHealth processes and ensure accurate billing.

The role includes finalizing PhilHealth claims, coding procedures with ICD-10, itemizing charges, and preparing monthly reports, with strict adherence to hospital policies and submission timelines. Workplace is hospital-based in Cagayan de Oro.