PhilHealth Officer /ICD-10 CODER

A PhilHealth officer in a hospital setting typically fulfills several key responsibilities related to the Philippine Health Insurance Corporation (PhilHealth). Here's a generalized job description for such a role:

• Claims Processing: The PhilHealth officer is responsible for processing PhilHealth claims for patients admitted to the hospital. This includes verifying patient eligibility, ensuring that all required documentation is completed accurately, and submitting claims to PhilHealth for reimbursement.

Billing and Documentation: They oversee the billing process related to PhilHealth claims, ensuring that all services rendered to patients are properly documented and coded according to PhilHealth guidelines. They may also collaborate with hospital billing departments to resolve any issues related to claims submission.

Compliance: The PhilHealth officer ensures that the hospital complies with all PhilHealth policies, procedures, and regulations. This includes staying up-to-date with any changes or updates to PhilHealth guidelines and implementing necessary changes within the hospital's billing and documentation practices.Education and Training: They may provide education and training to hospital staff on PhilHealth policies and procedures, including proper documentation practices and coding guidelines. This helps ensure that all staff members involved in the billing process are knowledgeable about PhilHealth requirements.

• Audit and Quality Assurance: The PhilHealth officer may conduct regular audits of PhilHealth claims to ensure accuracy and compliance with regulations. They may also implement quality assurance measures to improve the efficiency and effectiveness of the hospital's PhilHealth billing processes.

Customer Service: They serve as a point of contact for patients and their families regarding PhilHealth-related inquiries, providing assistance and guidance as needed. This may include explaining PhilHealth coverage, answering questions about claims, and assisting with claim disputes or appeals.

Coordination: They collaborate with other departments within the hospital, as well as external stakeholders such as PhilHealth representatives and government agencies, to facilitate efficient claims processing and resolve any issues that may arise.
Overall, the PhilHealth officer plays a crucial role in ensuring that the hospital effectively navigates the complexities of PhilHealth reimbursement processes while maintaining compliance with regulations and providing excellent service to patients.

Job Types: Full-time, Permanent

Pay: From Php20,

• 00 per month
  
  Benefits:
• Discounted lunch

Free parking

• Health insurance

On-site parking

• Paid training

Promotion to permanent employee
Schedule:

• 8 hour shift

Overtime

• Shift system

Supplemental pay types:

• 13th month salary

Overtime pay