Romart

Professional Healthcare Customer Service Specialist

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Overview

Looking for full-time work (8 hours/day)

at $8.00/hour ($1,408.00/month)

Associates degree

Last Active

January 10th, 2024 (79 days ago)

Member Since

June 16th, 2022

Profile Description

I worked as a US Healthcare customer service specialist with almost 7 years of healthcare and medical experience, I am dealing with members and providers checking eligibility, benefits, checking authorization, especially handling claims denials, how the claim will be paid, and large appeals review requests.
I have a knowledge of medical insurance policies and terminologies and I understand HIPAA regulations and patient privacy.
Some of the US healthcare Insurance that I handled are: 
-Original Medicare 
-Medicare Advantage plans 
-federal plans 
-Employer plans 
-Commercial plans
Responsibilities:
*Handling inbound and making outbound service calls
*Completing call logs and producing call reports.
*Managing Large numbers of claims to review disputes.
*Verifying member health insurance account
*Handling inbound calls: reviewing benefits and eligibility.
*Reviewing member claims utilizing the system to provide updates.
*Handling medical records for review disputes.
*Providing updates on the appeal status, sending an email for follow-up
*Checking the credentialing info
*Sending and checking explanations of benefits.
*Responsible for responding in a timely and courteous manner.
*Enjoys researching and following the requirement to utilize the work process to answer questions accurately.
So if you are looking for a creative, resourceful, and reliable person to work with feel free to set up an interview with me to discuss this further.

Top Skills

Office and Administration » Data Entry

Other Skills

Video Editing

Customer Support

Customer Support » Phone Support » English Speaking

Office and Administration » Email Management

Customer Support » Email Support

Customer Support » Technical Support

Office and Administration » Microsoft Excel

Basic Information

Age
Not Specified
Gender
Male
Website
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Address
Caloocan City, Metro Manila
Tests Taken
None
Uploaded ID
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