JOB DESCRIPTIONS
- minimum of three (3) days duty, Tuesday, Thursday, Friday.
- supervise and provide approval for prior letter of guarantee, prior authorization, letter of authorization issuance
- provide underwriting analysis in relations to new business account application and members medical service availment of hmo plan accounts
- provide analysis, evaluate, review claims of reimbursement for healthcare accounts
- approve and evaluate members utilization of healthcare benefits
- collect logistical, medical and collateral histories pertaining to the medical events in order to give case direction and as part of medical due diligence
- coordinate with healthcare providers and members, if such procedures is medically necessary for the Companies policyholders
- coordinate with Medical Director & Underwriting Officer for evaluation, health account management and comprehensive analysis
- provide reports in coordination with Medical Director to the BOD for progress, process, enhancement and policies of the Medical Group
- develop and adapt new policies and regulation enhancing the underwriting and procedure process of the Company
- organizing and supervise appropriate medical assistance for clients, this includes obtaining medical reports, organizing referrals, monitoring the patients condition, recommending appropriate medical procedures
- maintain high standards for detailed and accurate documentations including the consistent and contemporaneous updating of case files
- willingness to represent the Company to its various Medical Field Organizations and Associations
- Other duties and function that may tasked to perform by the Company’s Management
QUALIFICATIONS
- 3 years plus of post-graduation clinical medical experience
- healthcare (HMO) managed experience is a plus
- duly licensed Physician
- full current registrations to practice a medicine in the Philippines
- willing to work during weekened