Overview
Looking for full-time work (8 hours/day)
at $4.98/hour ($960.00/month)
High school diploma
Last Active
June 27th, 2026 (13 days ago)
Member Since
October 21st, 2023
Profile Description
Detail-oriented Healthcare Insurance Specialist with 3+ years of experience in member services, claims review, eligibility verification, and benefits administration. Skilled in analyzing medical claims, resolving member inquiries, processing payments, reviewing claim denials, and coordinating claim adjustments. Strong knowledge of HIPAA regulations, healthcare insurance policies, and customer service best practices. Proven ability to ensure accurate claim resolution while maintaining compliance and delivering exceptional member support.
## CORE COMPETENCIES
* Claims Review & Processing
* Member Eligibility Verification
* Benefits Explanation
* Healthcare Insurance Operations
* Claims Denial Analysis
* Claims Adjustment Coordination
* HIPAA Compliance
* Payment Processing
* Customer Service Excellence
* Issue Resolution
* Documentation & Record Management
* Medical Terminology
* Data Entry & Accuracy
* Regulatory Compliance
B2 SPANISH SPEAKER
## TECHNICAL SKILLS
* Claims Management Systems
* CRM Software
* Microsoft Office Suite
* Healthcare Insurance Platforms
* Data Entry & Documentation Systems
Top Skills
Coaching » Health And Wellness
Experience: Less than 6 months
Real Estate » Lead Generation
Experience: Less than 6 months
Customer Support
Experience: Less than 6 months
Other Skills
Accounting » Bookkeeping
Experience: Less than 6 months
E-Commerce » Logistics Management
Experience: Less than 6 months
Office and Administration » Communication » Spanish Bilingual
Experience: Less than 6 months
E-Commerce » Logistics Management » Freight Forwarding
Experience: Less than 6 months
Professional Services » Medical Services » HIPAA Compliance
Experience: 2 - 5 years
I have 3 years of working in a Blue Cross Blue Shiled reviewing claim , eligibility and prior authorization for medical policies.
Basic Information
- Age
- 34
- Gender
- Female
- Website
- Sign Up with Pro Account to View
- Address
- Caloocan, Metro Manila
- Tests Taken
- IQ
- Score: 105
- English
- C2(Advanced/Mastery)
- Government ID
- Sign Up with Pro Account to View
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