philhealth staff

2 weeks ago

Pasig, National Capital Region, Philippines TriCity Medical Center Full time ₱900,000 - ₱1,200,000 per year

Job Summary:

As a PhilHealth staff member, you will contribute to the contribute to the implementation of the National Health Insurance Program (NHIP) in the Philippines. Your role will involve ensuring access to affordable healthcare for all Filipinos, promoting health insurance awareness, and providing excellent customer service.

Key Responsibilities:

1. Member Services:

-Process membership applications and updates.

-Provide information on PhilHealth programs and benefits.

- Assist members with claims and billing inquiries.

2. Claims Processing:

- Evaluate and process health insurance claims.

- Conduct on-site visits to verify claims.

- Ensure compliance with PhilHealth policies and regulations.

3. Provider Relations:

- Establish and maintain relationships with healthcare providers.

- Monitor provider compliance with PhilHealth standards.

- Facilitate provider accreditation and re-accreditation.

4. Policy Development and Implementation:

- Assist in developing and implementing policies and guidelines.

- Conduct research and analysis to inform policy decisions.

5. Training and Education:

- Conduct training sessions for members, providers, and stakeholder

-Develop educational materials and resources.

6. Administrative Tasks:

- Maintain accurate records and databases.

- Prepare reports and perform data analysis.

- Participate in quality improvement initiatives.

7. Verification of Doctor's Accreditation

- Checking Doctor's accreditation via system.

Qualifications:

1. Bachelor's degree in relevant field (e.g., healthcare, social sciences, business administration).

2. Relevant work experience in healthcare, insurance, or customer service.

3. Strong communication and interpersonal skills.

4. Analytical and problem-solving skills.

5. Proficient in Microsoft Office and other software applications.

6. Ability to work in a team environment.

Job Type: Full-time

Benefits:

  • On-site parking
  • Paid training

Work Location: In person

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