HMO Staff
Job Description
Maintain an updated file of all HMOs. That includes policies and procedures on availment of diagnostic and medical services, doctor’s professional fee, list of accredited doctors, etc.
Facilitate Medical Staff Accreditation on respective HMOs.
Distribute accreditation forms and collects all pertinent documents as required by the HMO.
For Out-Patient (OPD) Cases, receives members ID for verification, inform ID holder of affiliated doctors with their specialization and refer cardholder to chosen doctor and schedule them for an appointment if necessary.
For Admission/In-Patient (IPD), receive the order sheet and member’s ID for verification, check the patient’s coverage, and notify the company guarantor then assist the patient at the admission dept. for proper documentation.
Facilitate credit and collection. Receive an original copy of the referral form and constantly follow-up HMO payment.
Encode report, memos, and correspondence concerning HMO.
Prepare a monthly statistical report on HMO utilization.
Performs other tasks that may be assigned from time to time.
Job Requirements
Bachelor’s degree of any business-related course.
Preferably with experience. Fresh graduates are welcome to apply.
Good communication skills and an ability to deal tactfully and effectively
Highly computer literate and organized and very keen to details.
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