job description
Join the Ophthalmological Foundation of the Philippines, Inc. as a PhilHealth Claims Specialist and play a pivotal role in ensuring seamless reimbursement processes for our patients. Based in the vibrant community of Canggu, Bali, this position offers a unique opportunity to contribute to healthcare administration while enjoying a dynamic work environment.
As a PhilHealth Claims Specialist, you will be responsible for accurately processing and recording patient reimbursement claims, liaising with PhilHealth representatives, and ensuring compliance with all regulatory requirements. Your expertise will directly impact patient satisfaction and operational efficiency.
This role is ideal for detail-oriented professionals with a background in healthcare administration or medical billing. If you are passionate about healthcare and thrive in a structured yet collaborative setting, we invite you to apply.
Responsibility
- Process and verify patient reimbursement claims with PhilHealth, ensuring accuracy and compliance with guidelines.
- Maintain detailed records of all claims submissions, approvals, and denials.
- Liaise with PhilHealth representatives to resolve discrepancies or delays in claim processing.
- Collaborate with medical and administrative staff to gather necessary documentation for claims.
- Monitor and report on claim statuses, providing updates to patients and internal teams as needed.
- Stay updated on PhilHealth policies, procedures, and regulatory changes to ensure compliance.
- Assist in training staff on PhilHealth claim processes and best practices.
- Generate reports on claim processing metrics and identify areas for improvement.
Qualifications
- Bachelor’s degree in Healthcare Administration, Medical Billing, or a related field.
- Minimum of 2 years of experience in PhilHealth claims processing or medical billing.
- Strong understanding of PhilHealth policies, procedures, and reimbursement guidelines.
- Excellent attention to detail and organizational skills.
- Proficient in using medical billing software and Microsoft Office Suite.
- Effective communication skills, both written and verbal.
- Ability to work independently and as part of a team in a fast-paced environment.
- Certification in medical billing or healthcare administration is a plus.