Member Benefits Officer

1 week ago

Ortigas, Philippines Medicare Plus, Inc. Full time ₱192,000 - ₱240,000 per year

Job description: Member Benefits Officer

A Member Benefits Officer, you are responsible for all the various functions of the company. Your primary function is to assist the sales, clients, and individual members from after-sales processes.

Your duties include but are not limited to the following:

  • As a Member Benefits Officer she will handle inquiries from email, mobile phone, viber, on request of members to seek approval of letter of authorization for consultation, laboratory test and procedures.
  • She will handle customer complaints arising from the members benefits.
  • She will assist Medicare Plus VVIP members in the hospital in case there is a need to facilitating medical support.
  • Perform other duties and responsibilities that may be assigned from time to time.
  • Attends inquiries and questions from providers.
  • Verifies and checks the member's coverage plan through the Medicare Plus system (HMPlus, card Printing, and Google data sheet prepared by Medicare team).
  • Analyzes the request of the provider for consultation and laboratory procedure if these are covered or within the parameter of the member's healthcare plan.
  • Advises the provider regarding the status of approval of the request.
  • Facilitates administration of health benefits to all HMO members or cardholders through proper coordination between the patient and the provider.
  • Handles all inquiries, concerns, and requests of the member relative to their health benefits.
  • Handles complaints and explains when the request is disapproved and assures that all concerns are answered.
  • Conducts orientation for corporate accounts on the benefits, inclusion, limitation, eligibility status, and processing procedures in using the HMO card.
  • Reviews the member's plan and utilization.
  • Updates members' approved utilization inti the HMPlus system.
  • Discusses and explain the healthcare benefit of the member.
  • Processes and issues the letter of authorization to the member.
  • Performs other tasks that may be assigned from time to time.

Job Types: Full-time, Permanent

Salary: Php16, Php20,000.00 per month

Benefits:

  • Additional leave
  • Company events
  • Health insurance
  • Promotion to permanent employee

Supplemental pay types:

  • 13th month salary

Ability to commute/relocate:

  • Pasig City: Reliably commute or planning to relocate before starting work (Required)

Job Types: Full-time, Permanent

Benefits:

  • Additional leave
  • Health insurance
  • Opportunities for promotion
  • Promotion to permanent employee

Experience:

  • Health Care: 1 year (Preferred)

Work Location: In person

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