JOB SUMMARY Responsible for tracking and monitoring in-patient utilization, relationship building with accredited service providers, and attending to all inquiries of healthcare members.
DUTIES AND RESPONSIBILITIES 1. STRATEGY MANAGEMENT a. Sets customer service objectives and strategies through customer servicing-oriented seminars in support of the goals and objectives of the Customer Service section of the Healthcare Division.
2. FINANCIAL MANAGEMENT a. Handles explanation of benefits and limitations of coverage to the admitted patients during confinement and assists patients upon discharge by computing chargeable expenses.
b. Facilitates Philhealth deduction.
c. Distributes check payments to providers.
3. CUSTOMER MANAGEMENT INTERNAL and EXTERNAL a. Explains the benefits and limitations of coverage to the admitted patients during confinement and assists patients upon discharge by computing chargeable expenses and facilitating Philhealth deduction.
b. Attends to all medical service availment inquiries/ concerns.
c. Provides assistance/ support in coordinating the schedule of Annual Physical Exam in designated clinics.
d. Issuance of Letter of Authorization for members admitted in accredited hospitals.
e. Monitors, records data, and checks status, benefits and medical records of admitted patients.
f. Collects consultations and referral forms from plan coordinators and specialist.
g. Establishes and maintains harmonious relationship with the coordinator, accredited physicians and significant work units of accredited hospitals/clinic.
h. Provides assistance/ support in conducting program orientation to hospitals, doctors and clients.
i. Conducts surveys for both provider partners and members admitted regarding services rendered by Cocolife Healthcare and partner providers.
j. Provides assistance/ support in negotiations of healthcare business.
k. Provides assistance/ support in identifying, soliciting and servicing the Healthcare's corporate accounts.
l. Provides assistance/support in new hospital and clinic accreditation and orientation. And reorientation of accredited providers.
m. Provides assistance/support in orientation of new accounts.
4. PROCESS MANAGEMENT a. Conducts surveys for both provider partners and members admitted regarding services rendered by Cocolife Healthcare and partner providers
b. Regular submission of monitoring documents and control measures to improve efficiency of the section
c. Prepares weekly reports and attend unit weekly meeting and an annual general meeting for all Medical Liaison nationwide
d. On the job training for newly hired Medical Liaison in certain areas
e. Adherence to all company policies, procedures and controls
5. LEARNING and GROWTH MANAGEMENT a. Undergo annual customer servicing oriented trainings and seminars. Using both external and internal resource persons.
b. Holds regular weekly meetings regarding account updates, individual client servicing feedback, and updated division, department, and company policies.
Qualifications: College degree preferably Nursing or any medical-related courses Good written and oral communication skills Relationship management skills Analytical skill Computer literate
