Medical Phils jobs in Makati

PRIMARY FUNCTIONS:

• Provides AMAPHIL members with a holistically positive and pleasant medical availment experience in the accredited providers.
• Addresses members’ concerns regarding their AMAPHIL coverage benefits
• Monitors daily patient’s progress chart to know patient’s needs
• Issues benefit reference, LOAs to the accredited providers every time there is availment based on the turn-around time.
• Provides feedback to Business Development department regarding customer satisfaction and customer complaints.
• Executes pre-identified processes and related tasks to delivery expected output

REGULAR TASKS:

• Responsible for the enrollment of corporate account and members in the system including the set-up of benefits.
• Serves as the point of contact for members, providers, corporate accounts for availment assistance and other availment related concerns.
• Process admissions and ensure that verification of coverability (COV) is conducted within 24 hours.
• Process and provides approval on the request for Letter of Authorization (LOA) for outpatient consult, laboratory, emergency, OPD-OR and clinic setting as long it is within the member’s benefit limit and not part of the exclusions.
• Performs claims adjudication for inpatient within 30 minutes once the member is for discharge and complete medical documents are provided.
• Coordinates with the corporate account requiring pre-approval prior the issuance of LOA.
• Screen and process medical reimbursement per member/corporate account endorsement.
• Process receive medical claims from the providers based on the approved LOA during availment to facilitate the payment.
• Process doctor’s enrollment and updating of CPT rates in the system.
• Liaise and process APE request of the corporate accounts
• Attend to customer service request from mobile app and chats from AMAPHIL Facebook account and website.
• Prepares and submits weekly transaction reports.
• Carry out ad hoc assignment

QUALIFICATIONS:

• Graduate of nursing or any medical allied/related course
• With at least 2 years of relevant experience in medical claims processing.
• With good communication skills both written and verbal
• Knowledgeable on MS office applications e.g. excel, word and ppt

Job Types: Full-time, Permanent, Fresh graduate

Benefits:

• Health insurance
• On-site parking
• Opportunities for promotion
• Paid training
• Promotion to permanent employee

Ability to commute/relocate:

• Makati: Reliably commute or planning to relocate before starting work (Required)

Education:

• Bachelor's (Required)

Work Location: In person