Claims processor

placeLas Piñas calendar_month 

Job Description

Posted on 6 April 2026

Key Responsibilities:

  1. Verify patient eligibility and PhilHealth membership details prior to admission or discharge
  2. Ensure completeness and accuracy of all required documents for PhilHealth claims
  3. Prepare, process, and submit PhilHealth claims within prescribed timelines
  4. Coordinate with patients, nurses, physicians, and other departments to secure necessary documentation
  5. Review patient charts, diagnoses, and procedures to ensure alignment with PhilHealth requirements
  6. Monitor and track submitted claims, including follow-ups on pending, returned, or denied claims
  7. Address discrepancies, deficiencies, or denied claims and initiate corrective actions
  8. Maintain organized records of all claims, submissions, and related documents
  9. Stay updated on PhilHealth policies, circulars, and regulatory changes
  10. Assist patients with inquiries related to PhilHealth benefits, coverage, and requirements
  11. Prepare reports on claims status, utilization, and collection performance
  12. Support audits and compliance checks related to PhilHealth processing

Qualifications/Requirements

Qualifications:

  1. Bachelor’s degree in Finance, Accounting, Business Administration, or related field

Work location

CITY OF LAS PIÑAS, NCR, FOURTH DISTRICT

Remarks

No additional remarks

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