• Provide basic health care services to employees
• Provide general first aid when needed
• Safe keep clinic records and prepare necessary health reports
• Assist company doctors in assessing health of employees
• Perform other related administrative tasks

• Assure accurate insurance claims adjudication in a timely manner.
• Assure timely submission of invoices/claims utilization report.
• Validate documents received as well as members' information to adjudicate the Claims based on the submitted information.
• Apply the Plan policy and its exclusion as well as underwriting guidelines to determine coverage for claims.
• Deny claims according to SOB, exclusions and policies.
• Assure timely payment of invoices from providers and ensure all information and documents needed are accurate and complete.
• Keep management aware of members' issues from providers to enhance operations and escalate to the higher-ups when necessary.
• Coordinate with providers all Claims unpaid and do reconciliation.
• Answer inquiries and handle complaints from providers.

• Liaise for the day-to-day administration of Health Plan, Insurance Coverage and Dental Program
• Report and monitor receipts of additions/deletions, covering endorsements, billing, membership IDs from the Principals, Dependents, and Extended Dependents
• File and monitor the status of claims filed for reimbursement by members after pre-adjudication of claims and completeness of claim documents in close coordination.
• Immediately report any case needing immediate attention.
• Perform other duties that maybe assigned from time to time by the company

Job Title: Admissions/Finance Floater VA 

Job Summary: The Admissions/Finance Floater VA plays a crucial role in connecting patients with healthcare administration in a virtual environment. This permanent position demands a compassionate approach to patient interactions while efficiently managing admissions and financial processes. The ideal candidate will be a licensed nurse, blending clinical expertise with robust administrative and financial skills. Candidates must be able to work in the Pacific Standard Time (PST) zone. 

Key Responsibilities: 

• Patient Intake and Information Gathering 
• Greet patients and families professionally and courteously via virtual communication platforms. 
• Conduct thorough interviews to collect comprehensive demographic and medical information. 
• Accurately enter and verify patient data in the electronic health record (EHR) system. 
• Insurance Verification and Financial Counseling 
• Verify insurance coverage and benefits for admitted patients. 
• Secure necessary pre-authorizations and referrals. 
• Explain hospital financial policies and assist patients in understanding their financial obligations. 
• Financial Planning and Analysis 
• Assist in developing and maintaining annual budgets for various departments. 
• Conduct financial forecasting and variance analysis. 
• Analyze patient care costs and recommend strategies for cost containment. 
• Revenue Cycle Management 
• Oversee the revenue cycle from patient registration through final payment collection. 
• Monitor key performance indicators (KPIs) and collaborate with clinical departments to ensure accurate charge capture. 
• Administrative Duties 
• Prepare and organize admission packets with relevant hospital information. 
• Maintain compliance with hospital policies, particularly regarding patient privacy (HIPAA). 
• Participate in ongoing training and education programs to enhance skills and knowledge. 
• Customer Service and Communication 
• Act as a liaison between patients, families, and clinical staff through virtual channels. 
• Address patient inquiries and concerns promptly and professionally. 

Work Environment: 

• Virtual work setting with the flexibility to manage tasks independently. 
• Availability during evenings, weekends, and holidays may be required. 

Reporting Structure: 

• Reports directly to the Admissions Manager or Finance Director. 

Performance Metrics: 

• Patient satisfaction scores, accuracy of patient information, and successful insurance verifications. 

• Provide high-quality patient care. Assist with continues development of staff
• Identify hazards in the workplace and provide solutions 
• Develop programs to maintain health and safety. Identify work-related risks 

• Provide basic healthcare and first aid for on-site injuries or illnesses.
• Maintain and manage all medical records ensuring confidentiality.
• Develop health and safety policies aligned with company standards.
• Conduct health screenings and organize wellness programs for employees.
• Collaborate with HR to manage employee leaves and returns-to-work.

• Assigns diagnosis codes according to the Official ICD-10-CM Guidelines for Coding and Reports for conditions which map to the Center for Medicare & Medicaid Services’ Hierarchical Condition Categories (CMS-HCC) applicable for the year(s) of service being reviewed.
• Conducts thorough review of charts by effectively using computer-assisted coding tools to review and interpret medical records and applies in-depth knowledge of coding principles to assign valid diagnosis codes which are supported by evidence in the medical record on the same date of service. 
• Demonstrates knowledge of what constitutes a medical record acceptable for supporting CMS-HCCs, including signature guidelines, member identifiers, provider types, medical record encounter/visit types, and places of service.
• Demonstrates advanced knowledge of medical terminology, anatomy and physiology as they pertain to assigning appropriate codes and identifying pertinent supporting information in the medical record.
• Manages individual quality of work & productivity toward meeting or exceeding targets.
• Consults Team Lead/Operations Manager and/or Coding SME timely and appropriately.

A Philippine Registered Nurse (PHRN) reviews and processes medical records, evaluates claims, and ensures compliance with healthcare standards. They support utilization management by conducting pre-authorizations, concurrent reviews, and discharge planning for healthcare providers, insurance companies, or medical facilities abroad. PHRNs may also assist in customer service roles, addressing patient or provider inquiries and ensuring efficient documentation to facilitate care coordination and claims processing."

Work Setup:

Training: Onsite for 4 to 6 weeks, followed by Work From Home (WFH)

Location: Pasay (MOA area)

Salary:

Up to ₱36,675 package

- Hardworking and result driven

- With leadership qualities. 

- Keen to details and analytical Willing to be assigned at the Head Office

- Supervise the incoming pharmaceutical products 

- Ensure goods are received and dispatched appropriately and productivity targets are met 

- Can start ASAP

Position: Medical Sales Representative 

SALARY RANGE: 18,000-30,000 (based on the skills and experience)

WORK SCHEDULE: Monday to Friday (8:30AM-6:30PM)

WORK LOCATION: QUEZON CITY

 Graduate of Bachelor’s Degree in any field

 Excellent Communication Skills

 Has a strong desire to do Sales and Marketing Functions

 Must be a Result-oriented and Customer-focused individual

 2 yrs experience or Having experience in a Medical Products

 Willing to do field work

 Willing to be trained

• 4 years College Graduate of any related course
• With at least 2 years of supervisory experience
• With Strong Personality
• Responsible for customer issues
• With Basic knowledge of Sales
• A bachelor's degree in business administration or hospitality is advantageous
• The ability to work in a fast-paced environment
• The ability to stand for extended periods.
• Strong management skills.
• Excellent organizational skills.
• Effective communication skills
• Exceptional customer service skills.
• Can work ASAP
• Willing to work at 2F Mega Building Brgy. Landayan San Pedro, Laguna
• Starting Salary is Php 20,000

• Evaluating levels of swallowing, speech and language difficulty
• Identifying treatment options
• Creating and carrying out individualized treatment plans addressing specific functional needs
• Teaching patients how to make sounds while improving their voices and maintaining fluency
• Working with children in developing and strengthening muscles used to swallow
• Counseling individuals on ways to cope with swallowing and communication disorders

•  Promote and sell medical supplies, diagnostic and hemodialysis equipment, products and services carried and distributed by the company.
• Establish new business and partnership to private and government accounts.
• Create and effectively execute sales and marketing plan.
• Religiously monitor and follow-up orders by accounts/customers to ensure that orders are delivered complete and on-time.
• Communicate/relay promptly all sales order and purchase order received to the person in-charge in the office;
• Coordinate all pending orders and advanced deliveries with office personnel in-charge;
• Closely monitor and follow-up all accounts receivables and collect promptly all payments available and remit immediately to the office or deposit directly to the company’s bank account;
• Report all concerns with the instruments installed in the area to the service coordinator and must be knowledgeable about these concerns at all times;
• Report all observations with the instruments installed in the area and how they are being used by end-users;
• Submit every Monday of the following week, all weekly expense, daily coverage report and area itinerary;
• Maintain and update the customer’s individual sales jacket (sales and collection) all the time;
• Attend product trainings and workshops, if any;
• MUST answer phone calls at ALL TIMES;
• Stay abreast on the latest updates and upgrades on the laboratory/dialysis instruments and equipment;
• Familiarize herself with competing brands/products present in the area;
• Maintains good rapport and courtesy to all clients/customers and colleagues at all times;
• Ensure that the customers are given high quality service and assistance all the time;
• All other task that may be directed and assigned to the EMPLOYEE by his direct supervisor and/or the COMPANY.

• Administer first aid medications to employees
• Assesses and determines the health status of employees, before or after an illness or absence, and issue necessary recommendations/ confirmations (leave form, medical clearance)
• Assist HR and Operations in the delivery of necessary health care services and refers the patients for proper case management, or for availing of HMO services
• Dispenses OTC (over the counter) medicines and issue prescriptions with allowable authorization limits
• Engages in health employment screening and participates in health maintenance examinations (pre-employment, for new hires, and regularization and annual physical examinations)
• Implements wellness program, immunization, and other Health Programs, in coordination with other departments/ division
• Maintain employees’ records of sick leaves, medical certificates, health records, and other relevant records and reports with the utmost confidentiality
• Manage clinic resources including medical supplies and maintain clinic equipment, material, supplies, and protective devices in good condition
• Provides individual counseling sessions to employees on health care and maintenance, based on health screening and health promotions activities, family planning, exercise, and nutrition
• Responsible for carrying out a wide range of occupational hygiene inspections within office premises
• Orients newly – hired/ regularized employees on health benefits
• Provides training and orientation to security guards on basic first aid procedures
• Coordinates with concerned departments and hospitals on work-related accidents and emergency situations
• Prepares and submits health and occupational reports required by local agencies