Profile Description
TeledirectPhilippinesAirbnb06/2013 – 07/2016 Handled GrievancesProperty Management for Property OwnersManaged pricing and date blocking Handled Reservation and Amenities RequestsInvoicing and DiscountManaged Repair Request and Mediation betweenOwners and RentersHandled refund request and Credit Request The ResultsCompanies08/22/2016 – 08/25/2017HealthcareRepresentative | Team Lead 1 year and 6 months02/17/Upgrade to see actual info/25/2017:Team Leader• Was profiled tofor Provider Services Line which handles claims/ explanation of denial and howto process appeal and dispute.• Claims processingfor Individual Providers and Medical Institutions.• Knowledge inclaims resubmission and codes.• Experience inclaims resubmission: Code 1 (Original Claim) Code 6 and 7 (Corrected Claim)• Handleseligibility and benefit inquiry, as well as authorization requirements andmedical policy. Microsourcing Philippines08/30/2017 –02/18/2020• Was assigned todo a medical claim processing and follow up for multiple doctors’ offices• We review medicalrecords if those are valid and qualified for the claim’s requirement• We make sure thatauthorizations and medical necessity are attached to avoid denied claims.• We check if thereis a need to resubmit the claim, void the claim or correct the claim submitted.• We usedSalesforce for the tools to process and enter the claim information.• We utilizeMicrosoft Office Suite/ Google Suite to edit the claim forms that needs to befilled out may it be a UB-04 Claims form or CMS 1500 form. Abbott RapidDiagnostics05/04/2020 – 05/ 21/2021• We are a DMEprovider specifically for HOME INR MONITORING. We accept members who areinterested, verify benefits and eligibility for qualifications, processauthorization requests, process reactivation, Supplies, Insurance Change,Equipment and Supplies and also Authorization follow-ups for multipleinsurances. The most• Claims processingfor Individual Providers and Medical Institutions.• Knowledge inclaims resubmission and codes.• Experience inclaims resubmission: Code 1 (Original Claim) Code 6 and 7 (Corrected Claim)• We do the thingsthe same with my previous company which is Microsourcing Philippines.• We make sure thatauthorizations and medical necessity are attached to avoid denied claims.• We check if thereis a need to resubmit the claim, void the claim or correct the claim submitted.• We usedSalesforce for the tools to process and enter the claim information.• We utilizeMicrosoft Office Suite/ Google Suite to edit the claim forms that needs to befilled out may it be a UB-04 Claims form or CMS 1500 form.• We also reviewEOB from the insurance companies.• Handling ERA aswell to better assess the claims we’ve submitted if the line items were paidcorrectly so we can submit a dispute right away.• Handling EFT tomake sure that the paid claims will be deposited to the right bank accounts ofthe insurance companies.• We used theCareVoyant as the tool to submit and receive claims update, authorization unitsused and etc.• Tools used:UHC Website for COB, Benefits and eligibility,Auth Submission and Claim address Upgrade to see actual inforecentrixHumana MilitaryMedi-calBCBS website to check home and host planAvaility for Upgrade to see actual infoZirmed100+ more insurance website utilization AVAILABLE TRADEINTERNATIONAL, LLC (Dayshift Freelance Job)February 2018 –August 06, 2021• provided supportto Logistics Companies before including Lead Generation for Amazon Fulfillment,Drayage, LTL, Partials, FTL and Over-the-road to Rail Conversion and basicknowledge on Transportation Management System for planning and coordination ofshipping, tracking, and delivering freight from one place to another. I alsocall logistics companies to book their shipment for whatever service they mayneed from us, and also call drayage to know if they have the earliest pick-updates and quotes for shipment. - Densley Photo andFilms – Social Media Manager | Operations Manager | Virtual Assistant Part Time(Dayshift Freelance Job)Job July 5, 2019 –August 13, 2021• Handled IGengagement and outreach•Handled basicphoto editing• Used Upgrade to see actual info for the task management• Send DMs topossible clients for Real Estate photoshoot• Directly assistclients in their day-to-day virtual navigation • Data entry• Appointmentsetting and calendar management• Email CustomerService - Account Management• Administrativeduties - A mix of voice and nonvoice duties. Virtual StaffingSolutions OPCDragon BallCompound Tacloban City, PhilippinesOctober 08, 2021 – February17, 2022Team Leader• Handled SelectQuote Campaign for Lead Generation under a Healthcare industry• Responsible forsupervising the team.• Managing andmotivating teaUpgrade to see actual infombers in a daily basis.• I am the contactpoint of teaUpgrade to see actual infombers, so communication skills will be excellent.• Set clear team goalsand KPIs.• Delegate tasksand set project deadlines.• Overseeday-to-day teams' operation and performance.• Do regularperformance evaluation.• Create a healthyand motivating work environment and atmosphere.• Develop awell-designed and motivating evaluation program.• Creating a careerpath for my agent’s progress. Feb 17, 2022 –currentRecruitmentCoordinator – Got promoted to Recruitment Generalist• Assisting in talent acquisition and recruitment processes• Administeringcompensation and benefit plans• Assisting intalent acquisition and recruitment processes• Conductingemployee onboarding and help plan training & development• Provide supportto employees in various HR-related topics such as leaves and compensation andresolve any issues that may arise• Promote HRprograms to create an efficient and conflict-free workplace• Assist indevelopment and implementation of human resource policies• Gather andanalyze data with useful HR metrics, like time to hire and employee turnoverrates CERTIFICATES fromPOLYTECHNIC UNIVERSITY OF THE PHILIPPINES Certificate of Participation:EmployerCompliance in DOLE RulingsCertificate ofParticipation: “New World, New Practices: Setting the RightCulture for Hybrid WorkplaceCertificate ofParticipation: “Mastering the Power of Leadership: MotivatingYour Team to Engage, Lead and Succeed.Certificate ofParticipation: #KilosKabataan: On Student Leadership towardsFilipino Youth’s Role in Nation BuildingCertificate ofParticipation: “Unleashing the Human Resources Prowess:Adaptability in Changing Environment”Certificate ofParticipation: “Business Strategy Development”Certificate ofParticipation: “Embracing Diversity: Equal EmploymentOpportunities”CERTIFICATE OFCOMPLETION: HIPAA Training for Medical Office Staff – 5 Standard Rule (Accreditedby IACET) Certification #: 347538
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