PHIC Billing Clerk

I. JOB SUMMARY

PHIC Staff ensures the correctness and completeness of claims. He/She also transmits, maps and verifies claim's status. She also interviews and accommodates patients for packages and promo's and other confinement-related documents and aids in the constructing quotation for financial assistance purposes.

II. PRINCIPAL DUTIES AND RESPONSIBILITIES

· Consistently implements the Vision-Mission, Core Values and Quality Policy.

· Refers to policy and procedural manuals to verify and confirm rules and regulations during the establishment of work.

· Shall ensure the maintenance of the patient's right to privacy and confidentiality;

· Shall organize workflow throughout the service;

· Shall perform other related functions as may be assigned by the immediate superior

· Shall refer promptly to immediate head cases of difficult situations or any unusual occurrences encountered during the entire shift duration.

· Shall read bulletins from the administration to keep abreast of changes in designated work or in the institution;

· Shall undertake actions to correct as well as prevent non-conformity that might be observed or found over the work area;

· Shall participate in regular meetings as well as conferences, continuing education programs of the department and unit. Exchange information with colleagues and make suggestions to better improve services;

· Shall adheres to infection control standards and protocols, patient safety standards as well as health crisis and emergency disaster management/ fire safety standards and protocols;

· May adjust daily schedules to accommodate unforeseen special circumstances such as medical emergencies or crisis;

· Shall perform new work as may be assigned by the Immediate Superior;

· Shall scrutinize new patients' Philippine Health Insurance Corporation(PHIC) Availment from other institutions;

· Shall Interview and introduce new and existing packages and promos to new; existing and reactivated patients;

· Shall collect and verify requirements;

· Shall endorse patients with complete requirements to admitting section;

· Shall recheck received flow sheets per month;

· Shall register new and reactivated patients to Philhealth Dialysis Database(PDD) if Billing Head is unavailable;

· Shall fill out PDD forms, validates diagnoses and laboratory results and sends forms to doctors for signature if Billing Head is unavailable;

· Shall attend meetings and seminars for PHIC update;

· Shall provide computation for quotation to patients who are trying to apply for financial assistance;

· Shall provide Certification of Confinement (45/90days); and

· Shall recheck received flow sheets per month;

· Shall send claim forms to Attending Physicians(AP) for signature;

· Shall recheck and verify AP's affixed signature; and

· Shall provide requested Hemodialysis Greenbook for confinement updates.

Billing and Claims processing:

· Shall segregate flow sheets per patient per billing period;

· Shall check and compare flow sheets from data from cashier(red folders);

· Shall highlight and validate dates;

· Shall recheck patient's benefit availment before proceeding;

· Shall attach and verify requirement for billing;

· Shall verify and attach requirements for billing;

· Shall recheck and fill out details in claim forms;

· Shall bill and encode data to the hospital's system;

· Shall recheck Bills before uploading and sending claims PHIC;

· Shall transmit claims to PHIC via e-claims;

· Shall file and generate transmittal letter and summary; and

· Shall map and verify claim updates.

Job Type: Full-time

Benefits:

• Staff meals provided

Work Location: In person