Claims Officer (HPPI)

👋🏻 Hi! We’re HPPI, part of the Hive Health Group

About us

HPPI is an HMO that is part of the Group of Companies, which is on a mission to provide the best-in-class health plans for small-medium enterprises (SMEs) in the Philippines.

HPPI’s 30+ years of providing care, combined with Hive Health’s innovative tech capabilities, enables the Hive Health Group of Companies to offer comprehensive, hassle-free digital health plans through our all-in-one platform. Together, we are revolutionizing access to quality, affordable healthcare for millions of Filipinos, one SME at a time.

Responsibilities

• Processing of out-patient and in-patient utilization
  • Checking the completeness of supporting documents
  • Encoding in the Enhanced Membership Monitoring System (EMMS) of details of utilization such as diagnosis, amount, procedure done, hospital bills, and professional fees
• Processing of members’ utilization reimbursement such as maternity assistance, ER changes, laboratory changes, professional fees, dental fees, and death assistance
• Processing of Account Receivables utilization (for special accommodation of non-members) if applicable
• Printing of utilization report summary from the EMMS for sending to the Providers (hospitals, doctors, clinics, labs)

Qualifications

• Must be willing to work onsite in Ortigas
• Education :
  • Bachelor's degree in Healthcare Administration, Business, or a related field.
• Experience :
  • Previous experience in healthcare claims processing, preferably in a startup or tech-driven environment.
  • Familiarity with medical coding and billing procedures.
• Curious, results-driven, ownership mentality with growth mindset
• Excellent verbal and written communications
• Collaborative team player with the ability to adapt quickly in a fast-paced environment
• Passion for innovation in healthcare

Benefits & Perks of Joining Us

• Health benefits and sick leaves
• Company laptop
• 13th month pay
• Career development and mentorship
• Access to global tech and advisory support from Harvard, Stanford, and more