I. JOB SUMMARY
PHIC Staff ensures the correctness and completeness of claims. He/She also transmits, maps and verifies claim’s status. She also interviews and accommodates patients for packages and promo’s and other confinement-related documents and aids in the constructing quotation for financial assistance purposes.
II. PRINCIPAL DUTIES AND RESPONSIBILITIES
· Consistently implements the Vision-Mission, Core Values and Quality Policy.
· Refers to policy and procedural manuals to verify and confirm rules and regulations during the establishment of work.
· Shall ensure the maintenance of the patient’s right to privacy and confidentiality;
· Shall organize workflow throughout the service;
· Shall perform other related functions as may be assigned by the immediate superior
· Shall refer promptly to immediate head cases of difficult situations or any unusual occurrences encountered during the entire shift duration.
· Shall read bulletins from the administration to keep abreast of changes in designated work or in the institution;
· Shall undertake actions to correct as well as prevent non-conformity that might be observed or found over the work area;
· Shall participate in regular meetings as well as conferences, continuing education programs of the department and unit. Exchange information with colleagues and make suggestions to better improve services;
· Shall adheres to infection control standards and protocols, patient safety standards as well as health crisis and emergency disaster management/ fire safety standards and protocols;
· May adjust daily schedules to accommodate unforeseen special circumstances such as medical emergencies or crisis;
· Shall perform new work as may be assigned by the Immediate Superior;
· Shall scrutinize new patients’ Philippine Health Insurance Corporation(PHIC) Availment from other institutions;
· Shall Interview and introduce new and existing packages and promos to new; existing and reactivated patients;
· Shall collect and verify requirements;
· Shall endorse patients with complete requirements to admitting section;
· Shall recheck received flow sheets per month;
· Shall register new and reactivated patients to Philhealth Dialysis Database(PDD) if Billing Head is unavailable;
· Shall fill out PDD forms, validates diagnoses and laboratory results and sends forms to doctors for signature if Billing Head is unavailable;
· Shall attend meetings and seminars for PHIC update;
· Shall provide computation for quotation to patients who are trying to apply for financial assistance;
· Shall provide Certification of Confinement (45/90days); and
· Shall recheck received flow sheets per month;
· Shall send claim forms to Attending Physicians(AP) for signature;
· Shall recheck and verify AP’s affixed signature; and
· Shall provide requested Hemodialysis Greenbook for confinement updates.
Billing and Claims processing:
· Shall segregate flow sheets per patient per billing period;
· Shall check and compare flow sheets from data from cashier(red folders);
· Shall highlight and validate dates;
· Shall recheck patient’s benefit availment before proceeding;
· Shall attach and verify requirement for billing;
· Shall verify and attach requirements for billing;
· Shall recheck and fill out details in claim forms;
· Shall bill and encode data to the hospital’s system;
· Shall recheck Bills before uploading and sending claims PHIC;
· Shall transmit claims to PHIC via e-claims;
· Shall file and generate transmittal letter and summary; and
· Shall map and verify claim updates.
Job Type: Full-time
Pay: Php10,000.00 - Php15,000.00 per month
Benefits:

• Staff meals provided

Schedule:

• 8 hour shift

Supplemental Pay:

• 13th month salary