PHILHEALTH STAFF

NUEVA ECIJA EYE AND LASER CENTER, INC; Cabiao; On-site; PHP 268,000 - 446,000; Full time

Job summary

NUEVA ECIJA EYE AND LASER CENTER, INC. is seeking a PhilHealth Claims Coordinator to manage eligibility, filing, and documentation for patient PhilHealth claims. You will verify member details, help patients complete forms, and coordinate with doctors, nurses, and billing.

In this role you will ensure timely submission, track claim status, and handle denials with corrective actions while maintaining an organized PhilHealth filing system.

Qualifications

• Knowledge of PhilHealth processes and requirements.
• Ability to coordinate with multiple departments.

Responsibilities

• Process PhilHealth eligibility, approval, and benefit-related requirements for patients.
• Verify patient information and PhilHealth membership details.
• Assist patients in completing required PhilHealth forms and documents.
• Coordinate with patients, doctors, nurses, billing, and other departments regarding PhilHealth requirements.
• Ensure completeness and accuracy of documents before submission of claims.
• Prepare and submit PhilHealth claims and supporting documents within prescribed deadlines.
• Monitor the status of submitted claims and follow up on pending, returned, or denied claims.
• Review returned or denied claims and coordinate necessary corrections or additional requirements.
• Maintain an organized and updated PhilHealth filing and monitoring system.
• Record and monitor approved, submitted, returned, denied, and paid claims.

Job description

• Process PhilHealth eligibility, approval, and benefit-related requirements for patients.

• Verify patient information and PhilHealth membership details.

• Assist patients in completing required PhilHealth forms and documents.

• Coordinate with patients, doctors, nurses, billing, and other departments regarding PhilHealth requirements.

• Ensure completeness and accuracy of documents before submission of claims.

• Prepare and submit PhilHealth claims and supporting documents within prescribed deadlines.

• Monitor the status of submitted claims and follow up on pending, returned, or denied claims.

• Review returned or denied claims and coordinate necessary corrections or additional requirements.

• Maintain an organized and updated PhilHealth filing and monitoring system.

• Record and monitor approved, submitted, returned, denied, and paid claims.