HMO Coordinator

2 weeks ago

Makati City, National Capital Region, Philippines Surevax Full time

Company Overview:

We are an emerging group of companies at the forefront of healthcare, fintech, and innovative solutions, dedicated to improving lives through cutting-edge technology and forward-thinking approaches. As we grow, we are seeking a proactive and highly organized HMO Coordinator to support our leadership team in navigating an exciting period of expansion and innovation.

Key Responsibilities:

  1. Patient Support & Experience

  2. Guide patients through HMO processes such as check-in, verification, and benefits explanation.

  3. Provide personalized, end-to-end support for members with complex healthcare needs.
  4. Ensure members feel informed, cared for, and prioritized throughout their calls/emails/visits.

  5. HMO Coordination & Processing

  6. Verify patient eligibility, coverage, and benefits with accuracy.

  7. Assist in securing LOAs (Letters of Authorization), approvals, referrals, and diagnostic requests.
  8. Coordinate with HMO providers, internal teams, and healthcare partners to expedite processing.
  9. Troubleshoot issues related to denials, benefit limitations, or discrepancies.

  10. Appointment & Care Coordination

  11. Assist members with scheduling doctor consultations, diagnostic tests, and follow-up appointments.

  12. Coordinate across departments (medical, billing, laboratory, imaging) to streamline patient flow.
  13. Monitor patient progress and ensure that each step of the care journey is well coordinated.

  14. Communication & Customer Service

  15. Provide clear explanations of processes, coverage details, and next steps.

  16. Address concerns or complaints professionally and escalate when needed.
  17. Maintain accurate and timely documentation of all interactions and service provided.

  18. Administrative & Operational Support

  19. Update patient logs, service reports, and daily activity summaries.

  20. Maintain a working knowledge of HMO policies, benefits, and guidelines.
  21. Identify inefficiencies in HMO processes and recommend improvements.
  22. Support internal teams with patient feedback collection and service optimization initiatives.

Qualifications:

  • Graduate of Bachelor's degree in Healthcare Administration, Office Management, or other related courses.
  • At least 3 years of relevant experience in HMO processes, hospital customer service, patient relations, or healthcare coordination.
  • Must have excellent communication and interpersonal skills.
  • Strong knowledge of HMO policies, claim processes, and medical workflows.
  • Ability to multitask and remain calm in fast-paced clinical environments.
  • Compassionate, patient-centric attitude.
  • Proficiency in basic computer applications and healthcare systems.

Why Join Us?

  • Be part of a growing healthcare and tech ecosystem dedicated to improving patient experience.
  • Opportunity to shape a premium concierge service from the ground up.
  • Collaborative work environment with continuous learning and development.
  • Meaningful work that directly impacts patient wellbeing.

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