Medical Officer

Primary Functions:

1. Provides AMAPHIL members with a holistically positive and pleasant medical availment experience in the accredited providers.
2. Addressed member’s concerns regarding their AMAPHIL coverage benefits
3. Issues benefit reference, LOA’s to the accredited providers every time there is an availment based on the turnaround time.
4. Executes pre-identified processes and related tasks to deliver expected output.

Regular Tasks:

1. Serves as the point of contact for members, providers, corporate accounts for availment assistance and other availment related query.
2. Process admissions and ensure that verification of coverability (VOC) is conducted within 24 hours.
3. Process and provides approval on the request for Letter of Authorization (LOA) for outpatient consultation, laboratory, emergency, OPD-OR, clinic setting and inpatient discharge availments as long it is within the member’s benefit limit and not part of the exclusions.
4. Attend to customer service request from mobile app, emails and chats from AMAPHIL facebook account and provides approval request from provider’s access and viber group chats.
5. Carry out ad hoc assignment.