Onsite Concierge

2 weeks ago

Makati City, National Capital Region, Philippines TASQ Staffing Solutions Full time

Qualifications:
> Graduate of 4-year medical-related course.
> Very good oral and written communications
> Persistent, flexible, and a team player
> With a pleasing personality and the confidence to meet with people at the different levels of the organization
> Willing to work during weekends and holidays
> Can work under pressure and meet deadlines with minimum supervision

Skills Required:
> Proficient in written and articulate verbal communication
> Proficient in Microsoft Office applications
> People-oriented and willing to extend hours just to ensure smooth availing of members.
> Self-starter and can work with minimum supervision
> Capable to do multi-tasking activities

Primary Functions:

  • Performs verification of coverability during member's admission
  • Creates and updates LOA in the system
  • Performs claims adjudication during discharge
  • Serves as the liaison officer for the member's ailment from admission to discharge.
  • Assist in out-patient availments

Regular Tasks:

  • Ensure that members' benefits are discussed with the admitted members within 24 hours from the
time of admission. Uncoverable items and possible excess must be highlighted.

  • Create LOA in the system. Ensure that it is updated every time there's a movement or special
instruction for the member's ailment.

  • Validate and ensure that the statement of accounts provided by the provider is complete before
claims adjudication.

  • Coordinate with the providers for the needed documents/requirements in order to facilitate the
discharge transactions.

  • Compute the eligible amount for cash loading covered by the Insurance Companies based on the
Final Statement of Account provided by the company Merchants during discharge.

  • Ensure that claims received are processed and submitted within the agreed TAT
  • Assist the providers in out-patient availments and submission of claims in the system.
  • Perform other duties and responsibilities assigned by the immediate supervisor from time to time.

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