ER - HMO Staff

12 hours ago

Imus A, Philippines Our Lady of the Pillar Medical Center Full time ₱150,000 - ₱250,000 per year

The Health Maintenance Organization Staff (Emergency Room) is responsible for approvals and reporting of all HMO- ER cases to its respective HMOs and Corporate Accounts. The position handles ER concerns and reports ER cases leading to confinement.

TECHNICAL (SKILLS)

  • Issues EMERGENCY referrals/consultations.
  • Verifies HMOs member ID card to their respective HMOs.
  • Issues and Requests Approval Code for the laboratory, diagnostic procedures requested by ROD/ER Consultant and affiliated Physicians holding their clinics beyond HMO office hours, (case to case basis) if deemed emergency in nature
  • Prepares Statement of Accounts (SOAs) for ER patients to indicate the disallowed/excess charges for payment of patients.
  • Checks the completeness of all ER availments provided to patients.
  • Sorts all ER patients' availments per HMO
  • Prepares and encodes daily summary of ER availments under HMO.
  • Guarantees ER claims and some OP procedures done on the ground floor
  • Reports ER leading to confinement patients to their respective HMOs
  • Prepares discharge and finalizes the Statement of Account for the in-patient.
  • Acts as a reliever in absence of HMO staff (HMO Operations staff).
  • Monitors LOA forms and requests additional forms to HMOs as needed

POSITION REQUIREMENTS

  • Graduate of any four-year course.
  • Experience in processing HMO is a plus.
  • Background or experience in a hospital/clinical setting is a plus.

Job Types: Full-time, Permanent

Benefits:

  • Company Christmas gift
  • Company events
  • Discounted lunch
  • Employee discount
  • Opportunities for promotion
  • Pay raise
  • Promotion to permanent employee

Application Question(s):

  • Can you start with OLPMC as soon as June 19, 2023?

Education:

  • Bachelor's (Required)

Experience:

  • HMO: 1 year (Preferred)

Work Location: In person

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