Application Form

Member Benefits Officer

Responsibilities:

  • Attend inquiries and questions from providers
  • Verify and checks the member’s coverage plan
  • Analyze the request of the provider for consultation and laboratory procedures if these are covered or within the parameter of the member’s healthcare plan
  • Advise the provider regarding the status of approval of the request
  • Facilitate the administration of health benefits to all HMO members or cardholders through proper coordination between the patient and the provider
  • Handle all inquiries, concerns, and requests of the members relative to their health benefits
  • Handle complaints and explains when the request is disapproved and assures that all concerns are answered
  • Conduct orientation for corporate accounts on the benefits, inclusion, limitation, eligibility status, and processing procedures in using the HMO card
  • Review the member’s plan and utilization
  • Updates members’ approved utilization
  • Discuss and explain the healthcare benefit of the member
  • Processes and issues the letter of authorization to the member


Qualifications:

  • Preferably with at least 2 years of work experience in customer service
  • Above-average communication and interpersonal skills
  • Must be customer-service oriented
  • Must have a keen eye for details
  • Good negotiating skills
  • Proficient in Microsoft Office Applications
  • Must be a graduate of any business-related course
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