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Social Insurance Assistants to be hired in PhilHealth Region 10

The Philippine Health Insurance Corporation (PhilHealth) was created in 1995 to implement universal health coverage in the Philippines. It is a tax-exempt, government-owned and controlled corporation (GOCC) of the Philippines, and is attached to the Department of Health.

The National Health Insurance Program was established to provide health insurance coverage and ensure affordable, acceptable, available and accessible healthcare services for all citizens of the Philippines. It shall serve as the means for the healthy to help pay for the care of the sick and for those who can afford medical care to subsidize those who cannot. It shall initially consist of Programs I and II or Medicare and be expanded progressively to constitute one universal health insurance program for the entire population. The program shall include a sustainable system of funds constitution, collection, management and disbursement for financing the availment of a basic minimum package and other supplementary packages of health insurance benefits by a progressively expanding proportion of the population. The program shall be limited to paying for the utilization of health services by covered beneficiaries. It shall be prohibited from providing health care directly, from buying and dispensing drugs and pharmaceuticals, from employing physicians and other professionals for the purpose of directly rendering care, and from owning or investing in health care facilities. (Article III, Section 5 of RA 7875 as amended)

Its stated goal is to ensure a sustainable national health insurance program for all, according to the company. In 2010, it claimed to have achieved universal coverage for 86% of the population, although the 2008 National Demographic Health Survey showed that only 38 percent of respondents were aware of at least one household member being enrolled in PhilHealth. Nevertheless, this social insurance program provides a means for the healthy to pay for the care of the sick and for those who can afford medical care to subsidize those who cannot. Both local and national governments allocate funds to subsidize the indigent.PhilHealth collects premiums, accredits providers, sets the benefits packages and provider payment mechanisms, processes claims, and reimburses providers for their services. PhilHealth is responsible for the oversight and administration of public sector insurance schemes. PhilHealth’s mandate is to provide health insurance coverage to all Filipinos. In partnership with Local Government Units (LGUs), PhilHealth has enrolled millions of families who otherwise have no access to health services.

Interestingly, PhilHealth Northern Mindanao (Region 10) is looking for 27 Social Insurance Assistants until November 2, 2022.

Twenty-seven (27) Social Insurance Assistant I (Php 25,745.62 Monthly Rate)

Place of Assignment & No. of Vacant Positions
  • Local Health Insurance Office (LHIO)- Cagayan de Oro (9)
  • LHIO- Iligan (6)
  • LHIO- Bukidnon (5)
  • LHIO- Ozamiz (4)
  • LHIO- Gingoog (3)
Job Summary
  1. Profile assigned accounts which should encompass verification of employer/ member data records and updating among others;
  2. Conduct employer/ member engagement activities or consultations for all assigned accounts to reconcile and validate records vis-a-vis employer payroll records/ annual income tax return (ITR);
  3. Conduct PIN verification of employers/ member;
  4. Ensure accurate monthly premium payments and reports submission;
  5. Ensure enrollment of assigned accounts to the EPRS online payment scheme;
  6. Generate the first billing statement for delinquent employers and monitor unwarranted claims;
  7. Monitor employer/ member compliance on issued billings/ SPAs;
  8. Prepare case folders of delinquent employers/ member for endorsement to Collection Section or Legal Office accordingly; and
  9. Submit monthly accomplishment/ monitoring status reports to PRO FOD/ Branc through Collection copy furnished the Formal Sector- MMG.
Qualifications
  • Education: Bachelor’s degree relevant to the job (degrees in the field of financial, business management or marketing)
  • Work Experience: 1 year of relevant experience (marketing, sales, financial or accounts management experience)
  • Training: 8 hours of relevant training

How to Apply

Qualified applicants are advised to send their complete application documents to the PhilHealth Regional Office – Human Resource Unit at 6/F Limketkai Gateway Tower B, Claro M. Recto Avenue, Cagayan de Oro City or email hr.pro10@philhealth.gov.ph with the subject line format: Application to vacant <Position Title> until November 2, 2022.

Requirements:

  1. Application Form;
  2. Properly accomplished, updated, and notarized Personal Data Sheet (PDS) or CS Form No. 212 (Revised 2017) with recent passport sized photo and Work Experience Sheet (WES);
  3. Authenticated Certificate of eligibility/rating/license (if applicable);
    a. Eligibility issued by the CSC
    b. Valid Professional license or Certificate of Registration issued by the PRC/SC
    c. Valid licenses issued by authorized regulatory agencies
  4. Copies of Scholastic/Academic Records – Transcript of Records and Diploma or Certification from the DepEd and/or the CHED on the authenticity and equivalency on the subjects/courses taken;
  5. Copies of Certificate of Trainings attended;
  6. Sworn Declaration/ Identification of Relatives form;
  7. Certification of No Conflict of Interest form; and
  8. Non-Disclosure Agreement form

APPLICATIONS WITH INCOMPLETE DOCUMENTS SHALL NOT BE ENTERTAINED.

History

THE call to serve the rural indigents echoed since the early '60s when the Philippine Medical Association introduced the MARIA Project which prioritized aid to communities in need of medical assistance. The Project would then be considered a valuable precursor to the Medicare program, from which a medical care plan for the entire Philippines was created. On August 4, 1969, Republic Act 6111 or the Philippine Medical Care Act of 1969 was signed by President Ferdinand E. Marcos which was eventually implemented in August 1971.The Philippine Medical Care Commission (PMCC) was tasked to oversee the implementation of the program which went for almost a quarter of a century.

In the 1990s, a vision for a better, more responsive government health care program was prompted by the passage of several bills that had significant implications on health financing. The public's clamor for a health insurance that is more comprehensive in terms of covered population and benefits led to the development of House Bill 14225 and Senate Bill 01738 which became The National Health Insurance Act of 1995 or Republic Act 7875, signed by President Fidel V. Ramos on February 14, 1995. The law paved the way for the creation of the Philippine Health Insurance Corporation (PhilHealth), mandated to provide social health insurance coverage to all Filipinos in 15 years' time.PhilHealth assumed the responsibility of administering the former Medicare program for government and private sector employees from the Government Service Insurance System in October 1997, from the Social Security System in April 1998, and from the Overseas Workers Welfare Administration in March 2005.

PhilHealth has six major membership categories covering nearly the entire population. Those who count under the (1) "Formal" sector are workers employed by public and private companies and other institutions. (2) "Indigents" (also called "PhilHealth Ng Masa") are subsidized by national government through the National Household Targeting System for Poverty Reduction. (3) "Sponsored Members" are subsidized by their respective Local Governments (LGU). (4) "Lifetime" (non-paying) members are retirees and pensioners which have already paid premiums for 120 months of membership. (5) "Senior Citizen" (under RA 10645) allows all Filipino citizens 60 years old and above are eligible to have free PhilHealth coverage. (6) The "Informal Economy" is composed of Informal Sectors, Self-Earning Individuals, Organized Group, Filipino with Dual Citizenship, Natural-Born Citizen. Although treated separately, the Overseas Filipino Workers (OFW) program or Migrant Workers are a part of the Informal Economy. Migrant Workers are sub-categorized; whether if they are land-based or sea-based (for seafarers).Since 1996, the benefits package and delivery system have improved. PhilHealth now has an Outpatient and Diagnostic Package limited to indigent beneficiaries. This addition creates nearly comprehensive coverage for indigents. In 2011, 23 Case Rates was introduced and in 2013, All Case Rates was fully implemented. All other beneficiaries have access to nearly all comprehensive services, excluding some outpatient care. PhilHealth has an accreditation program for private hospitals.

Source: PhilHealth NortMin Region

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