Prior Authorization Specialist - Medcore Solutions
(2025-10 - 2026-05)
- Processing initiation and follow up Prior Authorization for outpatient Radiology (MRI/CT Scan procedures) through Fast Auth EMR
- Requests patient Medical records from the doctors clinics, through phone, emails, fax
- Process authorizations through payers portal Like Evicore, Availity, Humana, Carecore etc.
- Highly observes HIPPA
Prior Authorization Specialist / Payroll - Phoenix Virtual Solutions
(2023-06 - 2025-06)
- Processing Authorization for Home Health care, for Personal Care Assistant, through Kantime EMR
- Coordinating with the state plan and Case Managers
- Requests authorization through Payer portal, fax, email.
- Highly observes HIPPA
- If already done with authorizations and the payroll team needs help I do assist in processing the clock in and out of the nurses
Client Reviewer/Prior Authorization - Access Healthcare Services
(2019-05 - 2023-06)
- Processing authorizations for out patient procedures, like radiology, surgical outpatients, laboratories, inpatient procedure, OB-GYN related procedures, VA related (initiation, follow up cases, and denied cases)
- Process through portals like NIA, Availity, Evicore, AIM, Humana, UHC etc
- Process through fax, phone, email
- Highly observes HIPPA
- EMR that we used is Athena health
Medical Information Officer/ Clinical Reviewer/Team Lead - Etiqa Life and General Assurance Corp.
(2014 - 2019)
- Approves and reviews authorization requests by clinics, hospitals for outpatient and inpatient procedures and admissions.
- Process inpatient billing process.
- Coordinates and endorses clients especially VIP patients to the clinics and major hospitals here in the Philippines.
- Team leader from 2016-2019
Private Nurse
(2012 - 2014)
- Handles patient care which includes giving medications, and giving quality patient care
Volunteer Nurse - Bulacan Provincial Hospital
(2009 - 2010)
- Handles patient care which includes giving medications, and giving quality patient care
Technical Representative/ Customer Representative - PNI - KMPG
(2008 - 2009)
- Handles inbound calls for technical support.
