Medical Virtual Assistant - My Mountain Mover - Remote
(2025-07 - 2026-06)
- Managed and updated patient medical histories, schedules, and eligibility information across multiple EHR systems, including OptumPro Portal, eClinicalWorks, and CURES.
- Transferred, verified, and organized lab results and prescription documents for streamlined clinical operations.
- Transcribed and summarized prescription documents and reviewed prior patient encounters to ensure proper medication continuation.
- Processed controlled prescriptions in strict compliance with CURES regulations.
- Submitted prior authorization requests for prescription medications on behalf of patients to insurance providers, ensuring all required documentation was complete and accurate.
- Pulled, logged, and returned patient and prescription-related phone voicemails to maintain consistent communication flow.
- Created future orders for patient appointments and clinical assessments.
- Managed medical records release, patient invoicing, and follow-up for payments.
- Maintained strict HIPAA compliance and confidentiality while handling sensitive patient information.
- Checked the patient's eligibility and benefits through the payer portal.
Senior Process Executive - Cognizant Technology Solutions Philippines Inc. - Remote
(2023-10 - 2025-05)
- Handled U.S. healthcare provider calls related to Medicare, Medicaid, and commercial insurance, offering support on various policy, claim, and plan matters.
- Assisted with eligibility and benefits, prior authorizations, claims status, and appeal processes.
- Ensured accurate information recording while maintaining compliance with healthcare regulations and delivering professional, solution-focused support.
Customer Service Representative - EXL Services Philippines - Remote
(2020-09 - 2023-09)
- Managed inbound calls as a front-line operator for a US life insurance provider, assisting callers with general inquiries and routing them to the appropriate departments.
- Provided accurate information on policy status, premium payments, and basic account details, ensuring a highly satisfactory customer experience.
- Maintained clear call documentation and demonstrated effective communication in a high-volume environment.
Member Services - Alorica Inc. - Cubao, Quezon City
(2019-11 - 2020-06)
- Responded to calls for senior citizens and ESDRD enrollees in Medicare Part D and Part A/B, assisting with prescription drug coverage.
- Addressed or escalated issues regarding claims, eligibility, prior authorizations, plan inquiries, and authorization submission requests.
- Delivered exceptional customer service tailored to the needs of vulnerable populations, while managing multiple systems to resolve issues efficiently.
- Submitted prior authorization request for prescription to the PA department on behalf of the member.
Provider Services - Concentrix CVG Inc. - Sta. Cruz, Manila
(2018-05 - 2019-10)
- Assisted dental providers with claims status, coverage verification, benefits explanation, eligibility, authorizations, network participation, and billing inquiries for PPO and HMO plans.
- Provided accurate dental claims data to the providers, utilizing multiple systems.
- Interpreted plan policies and maintained up-to-date provider records, demonstrating professional communication to enhance provider satisfaction and the efficiency of dental processes.
- Processed ERA enrollment from different dental offices, ensuring accurate and timely submission of enrollment applications and supporting documentation.
