Job Overview: A Registered Nurse (RN) accredited by the Philippine Health Insurance Corporation (PHIC) plays a critical role in providing quality healthcare services in accordance with PHIC's guidelines and policies. The nurse is responsible for delivering direct patient care, coordinating treatments, and ensuring the efficient utilization of Phil Health benefits for patients. They also work closely with doctors, healthcare professionals, and administrative staff to ensure accurate documentation and the timely submission of claims for Phil Health reimbursement.
Key Responsibilities:

• Patient Care and Support:
• Provide direct nursing care to patients by assessing their health status, monitoring vital signs, administering prescribed medications, and managing treatments.
• Perform nursing procedures such as wound care, catheterization, intravenous (IV) therapy, and other clinical tasks within the scope of practice.
• Ensure patients' comfort and safety by assisting with activities of daily living and responding to patient needs promptly.
• Monitor patient responses to treatment and medication, and report any significant changes in condition to the attending physician.
• PHIC Documentation and Claims:
• Accurately document patient care activities, including assessment data, interventions, progress notes, and outcomes in the patient’s medical record, as required by PHIC.
• Assist patients in understanding their Phil Health coverage and the benefits available for hospitalizations, surgeries, diagnostic procedures, and outpatient services.
• Ensure proper documentation for PHIC claims and verify that all services rendered to the patient are covered by Phil Health benefits.
• Collaborate with the hospital’s billing or administrative department to ensure the timely submission of Phil Health claims and resolve any issues regarding claims processing.
• Patient Education:
• Educate patients and their families about their medical conditions, treatment plans, and the utilization of their Phil Health benefits.
• Provide information on preventive healthcare, lifestyle modifications, and post-treatment care to promote health and well-being.
• Offer guidance on proper medication adherence, rehabilitation protocols, and the importance of follow-up visits.
• Coordination with Healthcare Team:
• Work collaboratively with physicians, specialists, allied healthcare workers, and administrative staff to deliver comprehensive care and treatment plans.
• Participate in rounds and clinical meetings to discuss patient care and ensure all members of the healthcare team are informed of patient progress.
• Coordinate with other departments (e.g., pharmacy, laboratory, radiology) to facilitate diagnostic testing, treatments, and procedures covered by Phil Health.
• Infection Control and Safety:
• Adhere to safety protocols and infection control guidelines to minimize the risk of healthcare-associated infections (HAIs).
• Ensure the proper sterilization and handling of medical equipment, and follow best practices for patient safety during procedures.
• Emergency and Critical Care:
• Respond promptly to emergency situations and provide life-saving interventions such as CPR, basic first aid, and emergency care, as necessary.
• Assist in the triage and management of patients in critical or life-threatening conditions in emergency situations.
• Advocacy for Patient Rights:
• Advocate for the rights and well-being of patients, ensuring they receive adequate healthcare services and that they are informed about their Phil Health entitlements.
• Support patients and families in accessing PHIC-related services, and ensure that all documentation is complete for claims processing.
• Health Promotion and Disease Prevention:
• Participate in health education campaigns and disease prevention programs, especially in community health settings, to promote wellness and reduce the burden of common diseases.
• Encourage patients to undergo regular health check-ups, vaccinations, and screenings as part of preventive care.
• Professional Development:
• Pursue continuous professional development and education through workshops, seminars, and courses related to nursing practice, Phil Health policies, and emerging healthcare trends.
• Stay up to date with changes in Phil Health regulations and ensure compliance with current guidelines.

Required Qualifications:

• Education:
• Bachelor of Science in Nursing (BSN) from an accredited institution.
• Must be a licensed Registered Nurse (RN) with an active license from the Professional Regulation Commission (PRC).
• Accredited as a healthcare provider by the Philippine Health Insurance Corporation (PHIC) for the delivery of health services.
• Skills and Competencies:
• Proficient in clinical nursing skills and patient care techniques.
• Strong knowledge of PHIC policies, benefits, and documentation requirements for claims processing.
• Ability to communicate effectively with patients, their families, and the healthcare team.
• Knowledgeable in medical terminology, health documentation, and the use of health information systems.
• Strong organizational and time management skills, with the ability to prioritize patient care and administrative duties.
• Compassionate, empathetic, and patient-oriented attitude in dealing with individuals from diverse backgrounds.
• Experience:
• At least one year of experience in a clinical or hospital setting is preferred but not required for entry-level positions.
• Experience with Phil Health claims processing, health insurance, or healthcare billing is an advantage.

Job Types: Full-time, Permanent
Pay: Php16,000.00 - Php17,000.00 per month
Benefits:

• Paid training

Schedule:

• 8 hour shift

Supplemental Pay:

• 13th month salary
• Overtime pay

Education:

• Bachelor's (Preferred)

Experience:

• Nursing: 1 year (Preferred)

Language:

• English (Preferred)