De Los Santos Medical Center is looking for a highly organized and detail-oriented PhilHealth Associate to support the efficient processing of PhilHealth transactions and claims. The successful candidate will play a key role in ensuring accurate documentation, patient eligibility verification, claims management, and compliance with PhilHealth policies while delivering excellent service to patients and stakeholders.<\/p>\n
Key Responsibilities
\nDocumentation & Patient Assistance
\nAssist patients in understanding and complying with PhilHealth requirements, policies, and procedures.
\nReview, validate, and organize PhilHealth documents to ensure completeness, accuracy, and timely processing.
\nVerify physician accreditation and ensure all supporting documentation meets PhilHealth standards.
\nProvide guidance to patients regarding benefit eligibility, claim requirements, and submission processes.
\nClaims Processing & Account Management
\nAssess patient eligibility for PhilHealth benefits and applicable deductions.
\nProcess PhilHealth claims accurately and efficiently in accordance with established guidelines and regulations.
\nMonitor and follow up on incomplete requirements to facilitate timely claim submission and approval.
\nInvestigate and resolve denied, returned, or disputed claims, including the preparation of appeal letters and supporting documents.
\nPrepare and submit required reports while maintaining accurate records of all transactions.
\nEnsure timely, compliant, and error-free claims processing to support hospital revenue cycle operations.
\nCompliance & Quality Assurance
\nMaintain compliance with PhilHealth regulations, hospital policies, and government healthcare standards.
\nCollaborate with medical, billing, admissions, and finance teams to ensure seamless claims management.
\nContribute to process improvements that enhance operational efficiency, service quality, and patient satisfaction.<\/p>\n
Qualifications
\nBachelor’s Degree in any relevant field.
\nDOH ICD-10 Training Certificate is required.
\nExperience in PhilHealth claims processing, hospital billing, healthcare administration, or related functions is an advantage.
\nStrong understanding of PhilHealth policies, healthcare documentation, and claims procedures.
\nExcellent attention to detail, analytical thinking, and problem-solving skills.
\nProficient in Microsoft Office applications and healthcare information systems.
\nStrong communication and interpersonal skills with a customer-focused approach.
\nAbility to manage multiple tasks effectively in a fast-paced healthcare environment.<\/p>\n
Why Join De Los Santos Medical Center?
\nJoin one of the Philippines’ trusted healthcare institutions and be part of a dedicated team committed to delivering exceptional patient care, operational excellence, and healthcare accessibility for the community.<\/p>\n","protected":false},"author":4768,"featured_media":0,"comment_status":"closed","ping_status":"closed","template":"","job_listing_type":[66],"job_listing_category":[],"job_listing_location":[483,536],"job_listing_tag":[],"job_listing_employer_type":[],"job_listing_specialization":[170],"class_list":["post-46272","job_listing","type-job_listing","status-publish","hentry","job_listing_type-full-time","job_listing_location-metro-manila","job_listing_location-quezon-city","job_listing_specialization-non-clinician"],"yoast_head":"\n