Responsible for receiving and processing bills from hospitals, doctors, and dentists. Ensures all bills are accurately processed and endorsed for check preparation to the Payment Processing Section by the specified target date.

Duties and Responsibilities:

Receive bills daily from the Medicard Claims Receiving Clerk. Ensure the receiving copy is returned to Medicard the same day and file the receiving summary by hospital or doctor.Encode pertinent information into the Claims Processing System (CPS) and verify benefits and limitations through Medicard Intranet Solutions V2.0. Determine the amount to be paid, ensuring that the amount and the number of patients match the hospital's billing.Verify that all hospital bills have an LOA (Letter of Authorization) or approval number to validate approved and disapproved charges. Attach a special accommodation form or letter for any special arrangements made by the Medicard Operations Department/CMG regarding hospital rates, professional fees, and other accommodations.Print and attach a utilization report for all in-patient and dental services. For out-patient consultations and medical services, attach a utilization report to the bills to check for pre-existing conditions (PEC), dreaded diseases (DD), and other relevant illnesses when necessary.Achieve the following daily processing quotas:24 records per day for In-patient services186 records per day for Medical Services221 records per day for Out-patient services368 records per day for Dental servicesSubmit processed bills to the Team Leader, Assistant Supervisor, Claims Assistant Checker, and Medical Administrator for verification and approval, along with two copies of the Daily Processed/Edit Summary (one for the checker and one as a receiving copy for files).Ensure all advances and cost-plus accounts are forwarded to the Medicard RMD Billing Clerk. Disapproved charges or accommodations extended to employees and agents must have a corresponding Debit Memo (DM).Implement any corrections and print the final Hospital Bill Analysis (HBA), Summary of Medical Services for Elective, ER & OP Consultations, and other related documents. Forward the approved bills, along with copies of the Summary of Bills for Payment Processing, to the Medicard Claims AP Receiving Clerk. Copies should be distributed to the Checker, AP Receiving Clerk, and for filing.Submit Daily Processed Reports and Weekly Status Reports to the Team Leader, Assistant Supervisor, or Claims Assistant Checker.Maintain files for the Daily Processed Reports, Receiving Summaries, Action Memos, Incident Reports, Logbooks, and other relevant documents.Ensure all bills received are processed within the designated target dates and forwarded to the Medicard Claims Payment Section by the check preparation target date.Perform other related tasks as assigned.Job Qualifications:1-2 years of experience in bookkeeping, billing, or accounting.Strong attention to detail with the ability to maintain accurate financial records and meet daily processing quotas.Proficient in using accounting software and the Microsoft Office suite.Excellent communication skills, both written and verbal, with a focus on customer service.Ability to work independently and collaboratively as part of a team.Strong organizational skills and the ability to manage multiple tasks and deadlines effectively.

---