Company Address: Brgy. Batino, Calamba, Laguna

Schedule: Mondays-Fridays 7am-4pm

Qualifications:

• With valid PRC License
• With BOSH Training Certificate
• Can start ASAP

MAIN FUNCTION:

• HMO Plan Administration
• Act as the primary point of contact between the company and the HMO provider.
• Manage the enrollment process of employees in the HMO plan, including their dependents, processing updates of member's details and employee exits.
• Handle day-to-day inquiries from employees about their HMO benefits, coverage, and eligibility.
• Coordinate and resolve any issues or concerns between employees and the HMO provider.

Claims Management

• Assist employees in processing medical claims and reimbursements through the HMO.
• Ensure timely submission and follow-up of employee medical claims.
• Verify and monitor claims documentation to ensure completeness and compliance with company and HMO policies.
• Coordinate with the HMO provider regarding claims issues, denials, and appeals.

Job Type: Full-time

Work Location: In person