Healthcare Medical Insurance Specialist

Overview

Looking for full-time work (8 hours/day)

at $7.00/hour ($1,232.00/month)

Bachelors degree

Last Active

November 22nd, 2024 (3 days ago)

Member Since

June 9th, 2020

Profile Description

Good Day! I’m Upgrade to see actual info G. Upgrade to see actual info, and you can call me Gi, from Calamba City, Laguna, Philippines. With a Bachelors Degree and a strong background in US Healthcare Industry for more than 4 years. 
I’ve been a Medical Virtual Assistant in a Clinic and Doctor’s Office specializing in Bariatric Surgery-Weight Loss and Medications that promotes mental and health wellness. I usually schedule Doctor’s appointment, meeting, scheduled surgery and virtual telehealth. I conduct patient intake and update patient files with accurate insurance information. I also do appointment scheduling for booking, cancellation and reschedule requests. I verify Insurance coverage by calling insurance companies to obtain patient’s eligibility and benefits. I obtain pre authorization requests for treatment and procedures making sure I submit all the necessary forms and required documents in a timely manner such as medical records, labs, and clinicals and follow up for the status. I  communicate with patient via email and for both inbound and outbound calls to explain their insurance benefits and coverage details such as deductible, copay and out of pocket expenses. 
I’ve also been a Healthcare Insurance Specialist at Genworth Long Term Care Insurance and Insurance Provider-Member Services Lead Representative and my main duties and responsibilities are handling inbound and outbound calls, answering inquiries via chat and email. I usually provide patient’s eligibility, benefits , exclusions and limitations of the plan, referral requirements,  prior authorization for procedures and claims processing making sure I address all inquiries regarding to medical billings, claims processing and reimbursement. I also process administrative and back office tasks such as patient demographic information change, refund and reissue of the check, mode cases, payment processing and extensive notes. Also, I evaluate submitted documents and forms if it is in good order to avoid denials.
I hones my expertise in Insurance Portals such as Exemplo (EHR), Availity, Trizetto, CoverUpgrade to see actual infods, Cigna healthcare, Emlblem Health, Navinet,  PEGA, CLOAS, Reporting Star, Superclue and EWD. I’m efficeint using Ring Central for all communications, Microsoft Offcie: teams, Outlook, Word, Excel Spreadsheet, Slides and PDF.
I am HIPAA Certified and have undergo Lean Data Training that helps me equipped in-depth knowledge and skills to handle sensitive patients information and ensure compliance within the industry regulations and requirements as well established. 
I’m seeking for a position where I can utilize my expertise in customer service sector and extensive healthcare support. 
Thank you so much for considering my application and I’m looking forward to connect and work with you.