Medical Officer
3 days ago
We are seeking a highly skilled Medical Officer to join our team at Amaphil (Advanced Medical Access Philippines Inc.). As a key member of our organization, you will play a vital role in providing excellent medical services to our clients.
The successful candidate will be responsible for managing patient care, processing medical claims, and ensuring that all transactions are completed efficiently and accurately. If you have a passion for delivering exceptional patient care and possess strong administrative skills, we encourage you to apply for this exciting opportunity.
Key Responsibilities
- Manage patient enrollment and benefits setup for corporate accounts
- Serve as the primary point of contact for members, providers, and corporate accounts for availment assistance and other concerns
- Process admissions and conduct verification of coverability within 24 hours
- Review and approve requests for Letters of Authorization for outpatient consultations, laboratory tests, emergencies, OPD-OR, and clinic settings
- Perform claims adjudication for inpatient cases within 30 minutes upon discharge and receipt of complete medical documents
- Liaise with corporate accounts requiring pre-approval prior to issuing Letters of Authorization
- Screen and process medical reimbursements per member/corporate account endorsement
- Receive and process medical claims from providers based on approved Letters of Authorization
- Enroll and update doctors' information, including CPT rates, in our system
- Attend to customer service requests through mobile apps, chats, and website inquiries
- Prepare and submit weekly transaction reports
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