Hi! I'm Shean.
Registered Nurse - CSR - Healthcare Virtual Assistant with 10 years experience on Insurance - Medical Eligibility & Benefits Verification, Precertification, Claims/Billing.
I'm currently working remotely as a Medical Biller for a US clinic specializing in Durable Medical Equipment (DME) focusing on Sales Order verifications, accurate claims submissions, following up claims denials, tracking claim status, insurance verifications, payment posting etc.
Former Healthcare Associate (CSR) for a US Health Insurance account with six years experience on:
- Medical Benefits and Eligibility / Insurance Verification
- Medical Claims
- Over the Phone Precertification/Pre-Authorization Requests
- Offline Pre-authorization Request (processing doctors request via fax)
- Inventory Specialist for Authorization (Delegating tasks to Offline Agents based on each Assigned Worklist, tracking Completion Rate and Aging Cases)
- Team Leader for 6 months - handled around 10-20 agents.
- Been recognized as ECSA or Employee Customer Satisfaction Awardee (2016) having an exceptional score for Customer Satisfaction in dealing with healthcare providers over the phone.
W/ background on Citrix, ICMS, VPNs, Zoom, Teams, Microsoft Office.
Adept in using Payer Portals and Availity.
Insurance type billed - Commercial & Medicare Advantage Plans (HMO, PPO, EPO, POS)
Medical Billing software used - Brightree (Sales Order creation & verification, Patients' account
documentation, DME Billing/Claims Submission)
With knowledge on Ebridge - platform use to access patients medical records.
Experience: 5 - 10 years
Experience: 2 - 5 years
Experience: 2 - 5 years
Experience: 2 - 5 years
Experience: 2 - 5 years
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