Skills
Medical administrative works
5-10 Years
Medical Va
1-2 Years
Medical Assistance
2-5 Years
Medical & Scientific Communication
1-2 Years
Accounting > Claims Processing
5-10 Years
Coding
5-10 Years
Fax coordinator , scheduler and a Registered Nurse
10+ Years
Medical Records Management
5-10 Years
Cost Estimate > Microsoft Excel
5-10 Years
HIPAA Compliance
5-10 Years
Denial Management
2-5 Years
Customer Support > Insurance > Prior Authorization> Medical Billing
5-10 Years
Accounting > Accounts Payable > Accounts Receivable > Billing
2-5 Years
Accounting > Accounts Payable > Accounts Receivable
2-5 Years
• Insurance & Claims Platforms: Availity, CMS, NPPES •
2-5 Years
Experience highlights
Medical Biller (OT, PT, ST, and SN)
BrightStar Care of Central and South Texas
·
July/2024
–
Present
Verified patient demographics and insurance eligibility. Submitted billing data to insurance providers. Analyzed EOBs and remits. Ensured medical information accuracy and claims alignment with therapy plans.
Medical Biller
Health Care Coding Integrity (HCI)
·
November/2023
–
Present
Medical billing and claims processing. Ensured accurate patient information and insurance submissions.
Hospital Staff, ICD-10 Coder and Medical Evaluator
Philippine Health Insurance Corporation
·
October/2017
–
Present
Assigned ICD-10-CM codes to diagnoses. Conducted medical record reviews. Processed claims from Legal Services. Ensured patient privacy and documentation accuracy. Claims adjudication and stakeholder engagement.
Claims Adjudicator
Philippine Health Insurance Corporation
·
January/2017
–
Present
Examined hospital claims for accuracy and completeness. Evaluated claims based on policy terms and coverage. Processed claims under investigation. Safeguarded patient privacy.
Medical Post Audit Secretariat
Philippine Health Insurance Corporation
·
January/2017
–
Present
Facilitated member meetings. Profiled claims by illness, age, hospital. Requested patient charts. Proofread medical evaluations for supervisory approval and legal endorsement.
