JOB SUMMARY
- The Medical Records Officer shall be primarily responsible for securing the timely, complete, and accurate accomplishment of both manual and electronic claims records (PHIC Claim Form 3 and Claim Form 4).
SPECIFIC DUTIES AND RESPONSIBILITIES
- Transcribe medical reports from patients’ clinical records and doctors’ progress notes into an electronic medical record system (Bizbox-PhilHealth Module) for the accomplishment of Claim Form 4 (CF4).
- Manually transcribe needed information in Claim Form 3 (CF3) from the charts of maternal patients who undergone either normal or cesarean delivery.
- A remark, “Prenatal Consultation was done in a Private Clinic,” must be written in Part II: Maternity Care Package under Prenatal Consultation if the needed information cannot be retrieved from the patient’s charts.
- Recognizes allowable medical abbreviations in both manual and electronic claims records and expands them into proper terminology as needed.
- Identifies inconsistencies, errors, and missing information in both manual and electronic claims records that could compromise the processing of PhilHealth claims.
- Follow up with healthcare providers, such as doctors and nurses, to ensure the accuracy and completeness of both manual and electronic claims records.
- Performs quality audit of manual and electronic claims records before endorsing it to the Billing and Claims Department for uploading to PhilHealth.
- Ensures completion of manual and electronic claims records within the accepted turnaround time.
- OPD TAT: within the day
- IPD TAT: within 24 hours after discharge.
- Addresses all backlogs on both manual and electronic claims records.
- Maintains close coordination with the nursing service office, hospitalist, and billing & claims department to immediately resolve issues for timely accomplishment of both manual and electronic claims records.
- Observe the confidentiality of information as stipulated in the Data Privacy Act of 2012.
QUALIFICATIONS
- Graduate of any 4-year medical course (preferably Medicine, Nursing, or Pharmacy).
- Has knowledge of medical terminology, anatomy and physiology, disease processes, medications, and laboratory values.
- Has knowledge of reading, interpreting, and correlating patient charts and records.
- Computer literate (basics of computer operation, MS Office specifically Excel and Word, computer systems, and printer operation)