Account Receivable Collection Representative - OPTUM GLOBAL SOLUTIONS (PHILIPPINES), INC.
(2023-12 - 2025-08)
- Review denied claims and identifies denial reason to possibly send out appeals and/or correspondence to the payers.
- Handled commercial Insurance and Medicare Insurance through our RCM tool which is Waystar.
- Properly annotate and update all assigned invoices in a timely and comprehensive manner.
- Assist in providing training, assistance, and/or guidance to team members resolving issues in claims through billing, collections, and/or denial review techniques.
- Continuously update job knowledge by participating in (weekly and monthly trainings), educational opportunities, and raising either inconsistencies or improvement opportunities.
Account Receivable Representative - PmaxGlobal
(2021-05 - 2023-06)
- Work with Client Managers in identifying, researching, and resolving issues which lead to claim denial, inaccurate or untimely filing of claims, and/or other billing and collection issues.
- Review pending initial claims and billing by use of resources such as online web, clearinghouse (RCM software), insurance portals or calling insurance companies to inquire and collect information regarding the denials of claims.
- Review denied claims and identifies denial reason to possibly send out appeals and/or correspondence to the payers.
- Properly annotate and update all assigned visits in a timely and comprehensive manner.
- Work with PMAXGlobal management and Client Managers to improve processes and increase accuracy and efficiency.
- Meet and/or exceed daily production and accuracy targets as defined by the management.
- Assist in providing training, assistance, and/or guidance to team members resolving issues in claims through billing, collections, and/or denial review techniques.
- Continuously update job knowledge by participating in training, educational opportunities, and raising either inconsistencies or improvement opportunities.
Transaction Processing Specialist - Accenture Cebu
(2012-09 - 2020-08)
- Identifying, researching, and resolving issues that lead to claim denial, inaccurate or untimely filing of claims, and/or other billing and collection issues.
- Review pending initial claims and billing by use of resources such as online web, clearinghouse, insurance portals, or calling insurance companies to inquire and collect information regarding the denials of claims.
- Meet and/or exceed daily production and accuracy targets as defined by the management.
- Assist in providing training, assistance, and/or guidance to team members resolving issues in claims through billing, collections, and/or denial review techniques.
Production Data Entry Specialist (Group Leader) - Lighthouse Software Cebu Inc.
(2012-01 - 2012-08)
- Follow up any outstanding information to keep the data base updated.
- Tracking various team reports such as intra, end of the day, weekly and monthly productivity.
- Ensure all reports are completed as client's specified matrix.
- Assist with other administrative duties that may arise from time to time.
Production Associate (Group Leader/ QA/ Checker) - Innodata Knowledge Services. Inc.
(2011-08 - 2012-01)
- Ensure daily reports
- Runs auto generated tools for html and xml auditing.
- Collaborate with client's specified workflow.
Primary Homes development, Camellia homes, Ayala land
(2011-02 - 2012-12)
- Serves customers by selling products and meeting customer needs.
Freelance Computer Technician - Freelance Computer Technician
(2010-05 - 2011-10)
- Home service repair of different types and model of desktop computers, printers and scanners.
- Installation of cabling system of internet café.
Corporate Technician - Silicon Valley
(2010-08 - 2011-01)
- Assigned in San Miguel Corporation Corporate office, Mandaue plant for the maintenance of systems and desktop computers of Silicon Valley warranties.
- Traveled to other San Miguel VisMin plant for the maintenance and repair of network and desktop computers.
- Repair and synchronize disconnected computers to the company enterprise network.
Computer Technician - Big Blue Computers
(2009-06 - 2010-03)
- Maintenance and repair of internet cafes computers.
