Abel Consultado
Provider Enrollment
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About
A dedicated professional with over three years of experience in customer service, patient care coordination, and provider enrollment. A developed strong expertise in healthcare administration, including insurance verification, claims processing (UB04 and CMS 1500), and EMR management with strict adherence to HIPAA compliance.
Experience
Provider Enrollment - MedMedtrix Manila
(2025-01)
- Updating Healthcare payors in every insurances to make providers In Network. Through Onboarding Providers, prepare, submit, and manage provider enrollment through Portals and Delegated Applications.
- Managing provider profiles on critical registries such as CAQH, PECOS, Availity, Portals, Modio, CredentialStream, Jira and the NPPES Registry.
Patient Care Coordinator - Allsectech Manila
(2024-03 - 2024-12)
- Manage the schedules and calendars of the doctor’s, and set appointments for the patients.
- Coordinating with the doctor’s offices for patient’s medical emergencies.
- Updating patient’s profile for verification and HIPAA purposes.
- Handle confidential information and documents with discretion and maintain their proper organization
Customer Service Representative (CSR) - Concentrix
(2022 - 2024)
- Managing Health Insurances
- Updating patient’s benefits & elegibilities
- Managing patient’s claim through UB04 claim form or CMS 1500, claims denial, billing services, and Account Receivable (AR).
Education
Bachelor of Science - Astronomy (Undergraduate) - Rizal Technological University (2021 - 2023)
Science Technology Engineering, and Mathematics - Sagkahan Nat’l High School - Senior High (2018 - 2020)
Pedro E. Candido Memorial National High School - Junior High (2014 - 2018)
