The Phil Health Officer is responsible for acquiring reparations for Philhealth claims, submission, and reviewing the eligibility of the guest in all aspects.
SPECIFIC DUTIES AND RESPONSIBILITIES
1. TECHNICAL
· Regularly secure and safe keep / organize the guest’s documents in proper filing
· Perform a detailed review of the accuracy and completeness of PHIC documents received from guests
· Revalidates the Accreditation validity period of the attending Nephrologist per guest.
· Facilitate the registration of the guests to the PDD portal
· Revalidates that the guest’s PDD registration is still active in the PDD portal prior to the guest’s first use of PHIC benefits in NHCSPI.
· Checks the accuracy of the guest’s date of treatment versus in the Hemodialysis treatment sheet.
· Timely perform generation of PHIC claims for each guest according to NHCSPI’s internal deadline
· Arrange, properly, and accurately accomplish and attach the guest’s PHIC documents to E-Claims
· Responsible for reviewing the encoded data in E-claims before transmitting.
· Timely and completely notify the Support Office - AR Team for RTH/ Denied notices received by PHIC thru Erth (electronic RTH system) or physical.
· Timely and accurately re-file RTH/ Denied claims.
· Can draft appeal letters/explanation letters to support RTH / Denied claims, subject to review and approval by Account Receivable Manager.
· Maintain updated data in PHIC Monitoring with PHIC Database, Tracker, Monthly sheet, and other monitoring and reportorial documents.
· Submit on a weekly basis to PHIC the Official Receipt for collections deposited by PHIC thru Auto credit payment.
2. ACCOUNTABILITIES
· Ensure Claims processing including but not limited to RTH/Denied filings is ACCURATE.
· No fraud details including not limited to session date/s and total number of treatments
· Avoid the reason of claims that can be caused by PHIC Accreditation Suspension “Double Filling”, “Fraud claims”, etc.
· All unpaid claims that result in uncollectible claims due to your negligence will be subjected to a charge.
Job Type: Full-time
Pay: Php450.00 per day
Schedule:

• 8 hour shift