Job Summary
在菲律宾首屈一指的医疗保健中心崇华医院,发挥影响力,提升您的职业生涯!
崇华医院正在招聘一位经验丰富、积极主动的 Claims Review Specialist who ensures that claims documents are in compliance with Philhealth circular and advisories. S/he ensures that there are no deficiencies, fraud, error on the submitted clinical records or pertinent documents for claims. Moreover, s/he works closely with the medical and other hospital staff for the resolution of problematic charts.
Additionally, s/he is expected to be knowledgeable about multiple PhilHealth benefits and claims management process (e.g inpatient benefits, outpatient benefits, Z benefits). S/he must also be competent in maintaining quality customer services towards patients, and patients’ significant others. Furthermore, s/he is entrusted to being capable of organizing patient records as needed with the process as well as maintaining strict confidentiality with handled documents.
工作职责和责任
- Receives claims form and countercheck with transmittal list provided / submitted.
- Checks for completeness of data and the required supporting documents attached.
- Processes documents in relation implementing guidelines and procedures pertaining to PhilHealth benefits claims.
- Ensure completeness of documentary requirements in the claims applications before forwarding to the next processing stage.
- Verify/validate information declared in the database to ensure correctness.
- Check the number of encoded claims and verify the accuracy of encoded information in the List of Claims Received.
资格
- A graduate of any bachelor’s degree.
- Possibly with at least three (3) years of relevant work experience in Hospital records management and insurance claims management.
- 有医疗保健行业经验者优先。
- Knowledgeable with medical terminologies.
- Possibly an ICD 10 encoder
- 证明对基本企业办公软件(包括 Microsoft Office 365 应用程序)的了解。
- Good communication skills. Proficiency in the Visayan dialect and/or Tagalog is required; ability to communicate well in English is an advantage.
