Ehmsie Doluntap

Experienced healthcare support professional with background in operations coordination, customer service, quality assurance, training, and outreach support. Skilled in communication, documentation, case monitoring, and working in fast-paced environments. Reliable, detail-oriented, and eager to transition into long-term remote work opportunities.

Outreach Coordinator at Optum (2023-09 – Present)

• Coordinated with the healthcare providers and clinics for medical record/ chart retrieval request.
• Managed outbound communications regarding patient chart collection and documentation.
• Ensured timely retrieval and submission of medical records while meeting productivity and quality targets.
• Collaborated with internal teams to resolve retrieval issues and improve workflow efficiency.
• Handled confidential patient information in compliance with HIPAA and company policies.
• Monitored retrieval progress and followed up on pending medical records requests.
• Assisted in onboarding and guiding newly hired employees on workflow and processes.
• Provided peer support anfd coaching the new team member to help improve productivity and quality.

Field Reviewer Advocate at Change Healthcare Philippines Inc. (2021-02 – 2023-09)

• Coordonated field reviewers' schedules, assignments, and provider visit logistics for onsite medical record retrieval.
• Served as liaison between field reviewers and healthcare provider clinics to ensure smooth chart retrieval process.
• Monitored performance and ensured field reviewers meet retrieval targets and deadlines.
• Managed coverage planning by sourcing and assigning replacement field reviewersfor absences or unavailability.
• Coordinated deployment and assigment of field reviewers prior to release to provider clinics and project.
• Reviewed and approved field reviewers' timesheets prior submission and processing.
• Ensured compliance with HIPAA and company policies in all field operations.
• Sipported end-to-end coordination between internal teams (Recruitment, Asset Management, and Operations) to meet project requirements.

Chart Retrieval Specialist at Change Healthcare Philippines Inc. (2017-12 – 2021-02)

• Contact physicians offices, clinics, and hospitals by phone to request patients medical records.
• Schedule appointments with provider offices for fax, email, mail, secure online portal, or onsite appointment.
• Follow HIPAA and company privacy policies to protect patient health information.
• Coordinate with field reviewer advocate, quality teams, and other department to resolve issues affecting chart retrieval.
• Meet daily and monthly productivity metrics, such as: number of outbound calls, scheduled retrieval appointments, QA scores, productivity and attendance goals.

Customer Service Professional (Bluecross Blueshield of North Carolina) at Convergys (2017-06 – 2017-12)

• Responded to inbound calls from healthcare providers regarding claims, eligibility, benefits, authorizations.
• Resolved complex provider issues by researching member accounts, claims history, and policy guidelines.
• Educated healthcare providers on insurance policies, procedures, and coverage guidelines.
• Documented customer interactions accurately in CRM systems and maintained detailed case records.
• Ensured compliance with HIPAA regulations and company policies when handling sensitive information.
• Met or exceeded key performance metrics, including customer satisfaction, call quality, and first-call resolution.

Customer Service Professional (Anthem) at EGS / Alorica (2014-08 – 2017-06)

• Handled inbound calls from healthcare providers regarding claims, member eligibility, benefits, and authorizations.
• Researched and resolved provider inquiries related to claim status, payments, and denials.
• Verified member and provider information while ensuring accuracy and compliance with HIPAA regulations.
• Educated providers on Anthem policies, procedures, and available self-service resources.
• Consistently met quality assurance standards, productivity goals, and customer satisfaction metrics.

Bachelor of Arts in English – Polytechnic University of the Philippines – Main Campus

Secondary Education – Sorsogon National High School

Primary Education – Sorsogon East Central School