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HMO Medical Benefits Associate
3 days ago
About Us:
30+ years of providing care, combined with our health's innovative tech capabilities, enables us 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 programConducts visits for confined clients, informs about benefits, advises on cost-saving, and oversees discharge processesMonitors reimbursement claims, ensuring accuracy in computations and timely processingWorks with patients and providers on hospital documentation, addressing various service needsConsults with Medical Coordinators and Network Provider Physicians, providing recommendations for approvalsMaintains strong relationships, acts as an authorized company representative in discussions and meetingsQualificationsMust be willing to work onsite in OrtigasMust be willing to do occasional night shiftsFamiliarity with medical indications for adjudicationPrior experience in roles such as medical liaison, provider relations, hospital HMO section staff, company nurse, teleconsult nurse, etc., is advantageousWillingness to conduct hospital visitsProficient problem-solving abilitiesCurious, results-driven, ownership mentality with growth mindsetExcellent verbal and written communicationsCollaborative team player with the ability to adapt quickly in a fast-paced environmentPassion for innovation in healthcare-
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