Job Vacancy Guagua, Pampanga Position PHIC Relief Clerk at Pampanga Medical Specialist Hospital

Pampanga Medical Specialist Hospital is currently seeking applicants for the position of PHIC Relief Clerk in the Guagua area. The available job type for this position is Full-time.

We are specifically looking for individuals who possess strong skills and have a minimum of beginners/seniors in the field. In addition to technical expertise, we highly value honesty, discipline, and a strong sense of responsibility in our employees.

Pampanga Medical Specialist Hospital operates within the (according to the company) industry. If you are interested in applying for this position and becoming a part of our company, we encourage you to submit your application.

Job Information

Job Description

QUALIFICATIONS:

1. Graduate of Business Administration, preferably major in accounting or background on Allied Medical Courses is an advantage.

2. Trained on ICD-10 and RVS Codes of PhilHealth.

3. Trustworthy and with good moral character.

4. Ability to work as part of a team.

5. Good interpersonal relationship with superiors, peers and associates.

6. Keen on details and analytical approach to work.

7. Computer literate.

8. Minimum of one (1) year related experience.

DUTIES AND RESPONSIBILITIES:

1. Shall make the PhilHealth (PHIC) rules and regulations the basis of daily work.

2. Perform the following activities as Dialysis Front Liner.

a. Printing PhilHealth Benefit Eligibility Form (PBEF) from the first to fourth set of dialysis patient schedule.

b. Pick-up Hospital claims discharged from Billing Section.

c. Encode and monitor Hospital claims on Patient Dialysis Journal.

d. Stamp Certified True Copy (CTC) on Hospital claims and will be forwarded to PhilHealth Accounting Clerk for checking the summary.

e. After summary checking of Hospital claims by PhilHealth Accounting Clerk, Hospital claims will be forwarded to the Billing Officer for signing CTC.

f. Processing of PHIC claims.

g. Issuing of certificate for the number of sessions consumed by the patient.

g.1 for financial assistance

g.2 for fistula

h. For new Dialysis Patient

h.1 Interview patients/members/representatives regarding PHIC category, history of confinements of patients and avail of PHIC benefits.

h.2 Verify to PHIC on-line system if member/patient is eligible to avail PHIC benefits, if YES, print the PBEF.

h.3 Provide checklist of all requirements and explain to member/representatives the requirements they need to submit before discharge.

h.4 Make members/patients/representatives aware of the PHIC rules and regulations.

h.5 Register patient to PHIC Dialysis Database (PDD) and print the PDD for signature to patient and Medical Director/HIC Representative.

h.5.1 Accomplish PDD registration form for signature to patient and Nephrologist.

h.5.2 Accomplish Certification on Diagnosis and Management of CKD Stage 5 for signature to patient and Nephrologist.

h.5.3 PDD Form, Registration Form and Diagnosis and Management of CKD Stage 5 Form will be transmitted to Regional Office by HIC Representative.

3. Perform the following activities as Dialysis Hospital Claims Processor.

a. Check and evaluate documents attached to hospital claims and ensure that they are complete and correct.

a.1 Accomplish the Claims Form 2 (CF2) based on hospital information system and statement of account and analyze the information of patient to ensure it is complete and correct.

a.2 Attach Claims Form 4 (CF4) to Hospital claims and analyze the information of patient to ensure it is complete and correct.

a.3 Completion of data on Claim Signature Form (CSF) and analyze the information of patient to ensure it is complete and correct.

a.4 Inputting diagnosis on Statement of Account (SOA).

a.5 Printing PDD letter and attach Hospital claims.

b. Sorting Hospital claims by doctors and arrange for signatures.

c. Forward Hospital claims to doctor’s clinic by their schedules.

d. After the Hospital claims were signed by the Doctors, claims will be forwarded to Medical Director Office for signature.

e. After signing by the Medical Director, Hospital claims will be arranged by date and be forwarded to the encoder for transmittal.

4. Perform the following activities as Dialysis Hospital Claims Encoder:

a. Encoding

a.1 Encode the claim information on Medi Link System (Provider).

a.1.1 Checking the eligibility of PHIC member.

a.1.2 Generate claims and search the PHIC ID number.

a.1.3 Evaluating the claim information CF1, CF2, CF4, SOA during encoding.

a.1.4 CF1, CF2, CF4 information.

a.1.5 Generate CF4

a.1.6 Attached the supporting documents; SOA, CSF, PDD, Official Receipt (if needed), CF4 with signature.

a.1.7 Submitting claims (check the date before submit)

a.1.8 Generating report

b. Encoding of Return to Hospital (RTH) claims.

b.1 Process and fix the CF4 section.

b.2 Generate and print CF4 to sign by the AP.

b.3 Resolving the problem on RTH claims by attaching the CF4 generated with sign by AP.

b.4 Attaching CF4 sign by the AP.

b.5 Re-file the claims.

c. Filing

c.1 Filling the claims already transmitted by date.

5. Perform other related duties that may be assigned with.

Job Type: Fixed term

Benefits:

• On-site parking

Work Location: In person

Requirements

• Experience in the Related Field (Preferred)
• Physically and Mentally Healthy
• Able to Work Under Pressure
• Good Communication Skills
• Minimum Education of High School Diploma
• No Criminal Record
• Minimum Age of 18 Years
• Able to Work in a Team
• Willing to Be Placed in the Designated Work Location

Company Address