Maricel Ginez

Healthcare and claims professional with over 5 years of experience in patient care, medical billing, and insurance claims. I've worked as a Provider Advocate at Optum Global Solutions and as a Claims Representative at ISG MNR Loaned, where I handled claim investigations, root cause analysis, and compliance with healthcare rules. Recently trained as a Virtual Medical Assistant, I'm skilled in telehealth coordination, HIPAA compliance, and EHR systems like Epic and Cerner.

I'm detail-oriented, reliable, and focused on accurate documentation and smooth patient-provider communication.

Provider Advocate - Optum Global Solution Inc.

(2021-03)

• Providers must ensure that patients understand their treatment options and voluntarily agree to them, respecting patient autonomy.
• Resolving Complaints: Addressing and resolving customer in professional and timely manner.
• Informing patients about their expected financial obligations upfront fosters trust and improves payment compliance.

Claims Representative - ISG MNR Loaned

(2026-02 - 2026-04)

• Investigate suspicious claims or issues (fraud, errors)
• Analyze data and find the root cause
• Recommend and apply solutions (fix or recover money)
• Ensure compliance with healthcare rules
• Help prevent future problems

Customer Service Representative - Convergys Inc.

(2017-09 - 2020-11)

• Managed credit accounts by handling billing inquiries, payment processing, and account updates through phone and email support
• Investigated and resolved billing discrepancies, provided clear explanations to customers, and ensured accurate account records
• Verified customer information, processed payments, and maintained compliance with company policies and data privacy standards
• Consistently met KPIs for call quality, customer satisfaction, and first-call resolution

Computer Secretary - Xavier Technical Center (2015)