PHILHEALTH STAFF
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About the role
The PhilHealth Staff is responsible for assisting in the overall operations of the Philippine Health Insurance Corporation (PhilHealth). This role involves supporting various administrative, customer service, and health insurance-related tasks to ensure efficient service delivery to members and stakeholders. The PhilHealth staff must ensure compliance with policies and contribute to the promotion of the National Health Insurance Program.
Key responsibilities
Address inquiries and concerns regarding PhilHealth coverage, benefits, and claims.
Guide members through the process of availing benefits, filing claims, and understanding insurance policies.
Assist in processing claims from accredited health care providers.
Verify claim documents for completeness and accuracy.
Collaborate with claims examiners to facilitate the timely and accurate processing of claims.
Maintain accurate records of member data and transactions in the PhilHealth database.
Ensure proper filing and documentation of all membership, claims, and administrative files.
Update member records as needed, including changes in personal information, dependents, or employment status.
Prepare and submit regular reports related to membership, claims, and payments.
Collaborate with other departments, such as the Claims and Benefits Department, to address member and provider concerns.