Philhealth Assistant

2 days ago

Taguig, National Capital Region, Philippines Healthway Cancer Care Hospital Full time ₱264,000 - ₱276,000 per year

The Philhealth Assistant checks, verifies, and processes all necessary documents needed for availing Philhealth benefits in line with the Circular and Memorandum of Philhealth Regional Office.

  • For Outpatient, the incumbent checks the necessary documents required to be submitted. If employed, CSF Form with signature of employer; If Individual payor, proof/certification of payment and Philhealth Benefit Eligibility Form ( PBEF) through Philhealth System and HIS before procedure.
  • For Inpatient, the incumbent checks the Philhealth Benefit Eligibility Form ( PBEF) through the Philhealth System and HIS upon discharge.
  • Validates the information in the PBEF vs CSF and requests for additional documents if with discrepancy.
  • Receives SOA of patients for discharge and checks the final diagnosis, clinical record, CSF form if complete and with signature of doctors. If no final diagnosis yet or with discrepancy, the incumbent coordinates with the Nursing Unit/Resident Doctor or with the Attending Physician.
  • Verifies the diagnosis or procedure if compensable. If Yes, the incumbent deducts the amount in the system by Split ICD-10/ Split Procedure. If not compensable, the incumbent stamps the SOA "Not Compensable"
  • Receives final SOA, which must be signed by the patient/member and the Billing Assistant
  • Scans forms, clinical records, and other pertinent documents required to file the claim.
  • Processes claims and attaches the scanned documents and transmits to Philhealth via Stash
  • Acknowledge payment received from Philhealth
  • Obtain a copy of the Official Receipt of the payment received from Philhealth and submit the OR at Philhealth Regional Office(PRO)-NCR South
  • Request for a copy of voucher at PRO-NCR South for the payment received to check the breakdown of payment
  • Distribute amount of payments to Hospital and doctors Professional Fee based on the voucher.
  • Other duties or other ad hoc tasks and projects that may be assigned

Requirements

  • At least a Bachelor's degree in any field
  • With at least 1 year of Philhealth billing or claims experience, preferably in the healthcare industry
  • Willing to work in Arca South, Western Bicutan, Taguig City
  • Willing to work on a rotating/shifting schedule (8am-5pm or 10am-7pm; may be assigned to work on weekends and holidays but will have 2 rest days per week)

Job Type: Full-time

Pay: Php21, Php23,000.00 per month

Benefits:

  • Additional leave
  • Company events
  • Health insurance
  • Life insurance

Work Location: In person

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