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Philhealth Job Hiring jobs in Cainta

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    • In this role, you'll guide members through their healthcare benefits, provide timely support, and ensure every interaction delivers a positive and seamless…
    • View all PhilCare Inc. jobs - Ortigas jobs - Scheduler jobs in Ortigas
    • Salary Search: HMO Staff (with Work from home schedule) salaries in Ortigas
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    • At least High School Graduate.
    • Can work in shifting schedules (Morning / Night Shift).
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    • Reviews and checks PHIC and OWWA forms for transmittal.
    • Processes forms and patients for direct filing of claims to PHIC due to late submission.
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    • The PhilHealth Billing and Claims Officer is responsible for the accurate preparation, submission, and monitoring of PhilHealth claims to ensure timely…
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Job Post Details

HMO Staff (with Work from home schedule) - job post

PhilCare Inc.
Ortigas•Remote
You must create an Indeed account before continuing to the company website to apply

Job details

Job type

  • Full-time

Full job description

Be the Difference in Every Member's Healthcare Journey!

Do you enjoy helping people and delivering exceptional customer service? Join our team as a Client Success Advocate / HMO Staff and become the trusted partner of our HMO members. In this role, you'll guide members through their healthcare benefits, provide timely support, and ensure every interaction delivers a positive and seamless customer experience.

If you're passionate about helping people and want to build a rewarding career in the healthcare industry, we'd love to have you on our team!

What You'll Do

  • Deliver exceptional customer service by assisting members through walk-ins, phone calls, and other communication channels.
  • Answer inquiries regarding HMO benefits, coverage, availment procedures, and member concerns.
  • Process and issue Letters of Authority (LOAs) for consultations, diagnostic procedures, and other approved healthcare services.
  • Assist members with enrollment updates, membership additions or cancellations, and ID card release.
  • Guide members through the reimbursement claims process and ensure all documentary requirements are complete.
  • Resolve member concerns promptly and escalate complex cases when necessary.
  • Provide personalized assistance to VIP members and help create a world-class client experience.
  • Review and approve eligible outpatient healthcare availments within authorized approval limits.
  • Monitor healthcare benefit utilization to ensure compliance with company policies.
  • Prepare operational reports and maintain accurate service records.
  • Perform other duties that support excellent client service and operational efficiency.

Who We're Looking For

✔ Bachelor's degree in any field (Medical Allied courses are an advantage).
✔ Experience in customer service, healthcare, HMO, insurance, hospitality, or a related industry is an advantage—but not required.
✔ Excellent communication, problem-solving, and interpersonal skills.
✔ Passionate about delivering outstanding customer experiences.
✔ Detail-oriented, organized, and able to thrive in a fast-paced environment.
✔ Proficient in Microsoft Office applications and willing to learn new systems.

Why Join Us?

  • Opportunities for career growth and continuous learning
  • Supportive, collaborative, and people-first work culture
  • Make a real impact by helping members access the healthcare they need
  • Comprehensive training to set you up for success

Ready to make every client interaction count? Join us as a Client Success Advocate and help deliver healthcare with care. Apply today!

Job Type: Full-time

Ability to commute/relocate:

  • Ortigas: Reliably commute or planning to relocate before starting work (Preferred)

Application Question(s):

  • What is your expected monthly salary?
  • When is your earliest availability to start working?
  • Are you amenable with Monday-Friday (Night Shift 8:00pm-5:00am) schedule?

Education:

  • Bachelor's (Preferred)

Work Location: Hybrid remote in Ortigas

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