Philhealth Officer

Duties and Responsibilities

1. Patient Services

• Verify Eligibility: Check if the patient is a current, active PhilHealth member and their premium is paid.
• Explain Benefits: Tell patients what medical costs their PhilHealth plan covers.
• Document Help: Help patients fill out the right claim form

2. Claims Processing

• Review Documents: Check patient records and medical forms to make sure they are correct and complete before sending them to PhilHealth.
• File eClaims: Submit all claims through the PhilHealth electronic system on time.
• Track Payments: Follow up on the status of submitted claims to ensure the clinic gets paid.
• Fix Errors: Correct and resend any rejected or returned claims.

3. Clinic Compliance and Records

• Stay Updated: Learn about new PhilHealth circulars and rules.
• Manage Records: Keep safe and organized files of all patient transactions.
• Assist in Audits: Help prepare documents if PhilHealth inspects the clinic

4. Clinic Coordination

• Work with Doctors: Talk to nurses and doctors to get missing medical data or clarify treatments.
• Work with Billing: Team up with the billing department to figure out patient deductions and total costs

Benefits:

• Company events
• Employee discount
• Promotion to permanent employee

Work Location: In person