PhilHealth Member Services Specialist

St. Camillus Medical Center; Pasig; On-site; PHP 201,000 - 312,000; Full time

Job summary

St. Camillus Medical Center is seeking a PhilHealth Staff in the Philippines to support the daily operations of PhilHealth-related administrative tasks.

The role focuses on assisting members with inquiries, guiding them through benefits, filing claims, and ensuring accurate processing of claims from accredited providers. The candidate will maintain member data and documentation, update records, and prepare regular reports related to membership, claims, and payments while coordinating with the

Responsibilities

• Address inquiries and concerns regarding PhilHealth coverage, benefits, and claims.
• Guide members through the process of availing benefits, filing claims, and understanding insurance policies.
• Assist in processing claims from accredited health care providers.
• Verify claim documents for completeness and accuracy.
• Collaborate with claims examiners to facilitate the timely and accurate processing of claims.
• Maintain accurate records of member data and transactions in the PhilHealth database.
• Ensure proper filing and documentation of all membership, claims, and administrative files.
• Update member records as needed, including changes in personal information, dependents, or employment status.
• Prepare and submit regular reports related to membership, claims, and payments.
• Collaborate with other departments, such as the Claims and Benefits Department, to address member and provider concerns.

Job description

St. Camillus Medical Center is seeking a PhilHealth Staff in the Philippines to support the daily operations of PhilHealth-related administrative tasks.

The role focuses on assisting members with inquiries, guiding them through benefits, filing claims, and ensuring accurate processing of claims from accredited providers. The candidate will maintain member data and documentation, update records, and prepare regular reports related to membership, claims, and payments while coordinating with the