Claims Assistant/Specialist For Pooling

3 days ago

Pasig Office Hybrid, Philippines Hive Health Full time ₱1,200,000 - ₱2,400,000 per year

Ready to make an impact? At Hive Health and HPPI, a subsidiary of Hive Health, we're on a mission to make healthcare radically more accessible for all—and we need passionate, driven individuals to help us make it happen. If you thrive in a fast-paced, innovative environment and want to work on solutions that truly matter, we'd love to meet you

 Hi We're HPPI, part of the Hive Health GroupAbout us

HPPI is an HMO that is part of the Hive Health Group of Companies, which is on a mission to provide the best-in-class health plans for small-medium enterprises (SMEs) in the Philippines.

HPPI's 30+ years of providing care, combined with Hive Health's innovative tech capabilities, enables the Hive Health Group of Companies to offer comprehensive, hassle-free digital health plans through our all-in-one platform. Together, we are revolutionizing access to quality, affordable healthcare for millions of Filipinos, one SME at a time.

Target start date: December 2025

Responsibilities

  • Processing of out-patient and in-patient utilization

    • Checking the completeness of supporting documents

    • Encoding in the Enhanced Membership Monitoring System (EMMS) of details of utilization such as diagnosis, amount, procedure done, hospital bills, and professional fees

  • Processing of members' utilization reimbursement such as maternity assistance, ER changes, laboratory changes, professional fees, dental fees, and death assistance

  • Processing of Account Receivables utilization (for special accommodation of non-members) if applicable

  • Printing of utilization report summary from the EMMS for sending to the Providers (hospitals, doctors, clinics, labs)

  • Perform other functions that may be in line with business needs

Qualifications

  • The first month of employment will be fully onsite, transitioning to hybrid work afterwards

  • Education:

    • Bachelor's degree in Healthcare Administration, Business, Finance, or a related field.

  • Experience:

    • Previous experience in healthcare claims processing, preferably in a startup or tech-driven environment.

    • Familiarity with medical coding and billing procedures.

  • Curious, results-driven, ownership mentality with growth mindset

  • Excellent verbal and written communications

  • Collaborative team player with the ability to adapt quickly in a fast-paced environment

  • Passion for innovation in healthcare

Join our team as we revolutionalize healthcare in the Philippines—and beyond

Day 1 benefits for full-time employees – because we practice what we preach Enjoy comprehensive healthcare coverage for you and your dependent, and paid time off from the start.
Grow with us – mentorship, career development, and learning opportunities to help you thrive.
Global connections – gain insights and support from top minds at Harvard, Stanford, and beyond.

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