Philhealth Staff

4 days ago

Quezon City, National Capital Region, Philippines METRO NORTH MEDICAL CENTER AND HOSPITAL, INC. Full time ₱150,000 - ₱250,000 per year

DUTIES AND RESPONSIBILITIES

· Responsible for processing and preparing documents for Case Rate claims of both in-patient and out-patient.

· Checks the system of Philhealth (PORTAL) if the member or dependent is eligible to use the benefit of Philhealth.

· Records daily Medicare claims to daily monitoring logbook.

· Endorses Philhealth forms to the Chief Accountant for signature on claim form 2 Part IV- Certification of Institutional Health Care Provider.

· Reviews data encoded; ensures that true and accurate data are encoded in all patients' records.

· Reviews actual charges and Case Rate deduction.

· Processes Claim Form 2 based on patients' records including diagnosis from admitting, final diagnosis, ICD 10 code and RVS code.

· Reconciles all data in Philhealth Claim Form 2 with the statement of account data and philhealth forms.

· Reviews doctors' name, philhealth accreditation number and professional fees.

· Attached OR tech in philhealth forms of patients who were operated on.

· Prepares hospital and doctors waiver for Case Rate and/or direct filing claims.

· Monitors and encodes direct filing claims.

· Accomplish Case Rate RTH or claims returned to hospital by Philhealth Office for completion and refilling.

KNOWLEDGE AND SKILLS

Education:

· Must be a graduate of any 4-year course.

· Graduate of any medical course is an advantage.

Work Experience:

· With or without experience; willing to be trained.

· Knowledgeable in hospital information system.

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