About this role
Role Overview
- Checks for newly admitted members with the admitting section of each assigned hospital and checks the ER for possible admissions from time to time
- Informs the TL of all admitted members and possible admissions if applicable, as well as requests for preapproval received with all the necessary details and discusses the appropriate cost containment measure to be applied to the case
- Field LO visits the member to get the history of present illness and other pertinent information and explains to the admitted members: the benefits and limitations of his/her coverage
- Liaison Officers shall inform the member of the required documents and discharge process of the said hospital
- Gathers the necessary information about the member's availment, through patient's charts and through the attending physician or coordinator and monitors the progress of the course in the ward for still admitted patients of their respective hospitals to determine early opportunities for discharge and to ensure that management is medically necessary
- Issues letter of authorization for admitted members at assigned hospital for each covered availment and personally makes the confined member sign the said issued LOA
- Coordinates the applied cost containment measure with the attending physician such as updating progress and recovery of the member to facilitate earlier discharge of the member as part of the LOS management or steerage options and bridge the concerns of the admitted members if any
- Assists admitted members during discharge and offers other services such as but not limited to scheduling of follow ups, home service, pharmacy service, telemed etc.
- Reviews the Itemized bills of the member to check for unusual charges and properly endorses the final coverage upon discharge, payables of the member as well as the disapproved charges to the hospital
- Updates all discharge details in MIMS and attaches all pertinent document in the shared folder with claims upon discharge
- Accomplishes progress notes duly signed by patient daily
- Sends location to Team leader each time he/she transfers from home hospital to the other
- Sends itinerary to TL daily
- Perform other task that may be assigned from time to time
Requirements
- Graduate of 4-year medical course
- With or without experience
- Willing to undergo training in Makati and do fieldwork
Benefits
- Health insurance
- Professional development opportunities
- Employee training and support