HMO Medical Benefits Associate

2 weeks ago


Pasig, National Capital Region, Philippines Hive Health (YC S21) Full time
Hi We're HPPI, part of the Hive Health Group

About Us

Group of Companies, which is on a mission to provide the best-in-class health plans for small-medium enterprises (SMEs) in the Philippines.

HPPI's 30+ years of providing care, combined with Hive Health's innovative tech capabilities, enables the Hive Health Group of Companies to offer comprehensive, hassle-free digital health plans through our all-in-one platform. Together, we are revolutionizing access to quality, affordable healthcare for millions of Filipinos, one SME at a time.

Responsibilities

  • Main point of contact for corporate accounts, ensuring proper adjudication of member availments in the group hospitalization program
  • Conducts visits for confined clients, informs about benefits, advises on cost-saving, and oversees discharge processes
  • Monitors reimbursement claims, ensuring accuracy in computations and timely processing
  • Works with patients and providers on hospital documentation, addressing various service needs
  • Consults with Medical Coordinators and Network Provider Physicians, providing recommendations for approvals
  • Maintains strong relationships, acts as an authorized company representative in discussions and meetings

Qualifications

  • Must be willing to work onsite in Ortigas
  • Must be willing to do occasional night shifts
  • Familiarity with medical indications for adjudication
  • Prior experience in roles such as medical liaison, provider relations, hospital HMO section staff, company nurse, teleconsult nurse, etc., is advantageous
  • Willingness to conduct hospital visits
  • Proficient problem-solving abilities
  • Curious, results-driven, ownership mentality with growth mindset
  • Excellent verbal and written communications
  • Collaborative team player with the ability to adapt quickly in a fast-paced environment
  • Passion for innovation in healthcare

Benefits & Perks Of Joining Us

  • Health benefits and sick leaves
  • Career development and mentorship
  • Access to global tech and advisory support from Harvard, Stanford, and more

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