Insurance Verification Specialist |Medical Records Nurse|VA

Overview

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

at $7.80/hour ($1,372.80/month)

Bachelor in Science in Nursing

Last Active

April 26th, 2024 (yesterday)

Member Since

December 18th, 2016

Profile Description

A Registered nurse and a certified medical virtual assistant with 2.5 years of bedside care experience and 6 years of job experience in  Business Process Outsourcing (Healthcare) as a Medical Data Analyst/ plus 2 years experience as a Virtual Assistant for Home Health. I am also certified in HIPAA Compliance and attended an OASIS training before becoming a VA. I have advanced knowledge of the US healthcare system and different health insurance plans. A highly organized, fast learner, attentive to details and ensures 100% quality of work.

Upgrade to see actual info is an experienced and hard-working registered nurse, with a decade of experience both in the hospital & office set-up. She has advanced knowledge of the US healthcare system which includes worker's compensation benefits and home health. Upgrade to see actual info's colleagues at previous works describe her as enthusiastic, self-motivated, hardworking, flexible, patient, and honest. She always accomplishes any task assigned efficiently &promptly. She is professionally motivated by the desire to do tasks to the best of her abilities. Now venturing into the exciting world of virtual healthcare, Upgrade to see actual info is more than ready to take on any challenge using her knowledge and skills.
TOOLS:
Pverify / Availity
Zoom, 
Microsoft Office
EMR/EHR(Practicefusion & Athena)/E-claims/E-clinicals,
 Google Spreadsheet, 
Adobe Acrobat, 
OASIS (Outcome and Assessment Information Set/ Kinnser/ Axxesscare, Slack/Notion/Click-up
 ================================================================= WORK EXPERIENCE:                                                                                                                 1. Upgrade to see actual info| Medical Virtual Assistant | Home Health Care Intake/ Data Entry & Medical Records Review | Insurance Verification Specialist
*Review Home Health referral PDFs Medical Records & enter the specific orders (Skilled Nursing, Wound Care, Medication Management, Physical Therapy, Occupational Therapy, Home Health Aide Services, etc.) into the Intake form.
*OASIS trained for Medicare home health claims.
*Identifying the diagnosis codes (ICD-10) which is/are related to the Home Health plan of care.
*Verifying the patients' insurance eligibility using an online tool (Pverify & Availity).  
*Send referral packages to Home Health agencies in Texas, USA.     

  2.Upgrade to see actual infoDepartment of Health Philippines | Public Health Associate 
* Collection and validation of health-related data.
*Submit health reports/data/information to DOH Regional Office and Central Office

3. Upgrade to see actual infoCognizant Technology Solutions | Data Analyst Nurse (Health Insurance Claims) 
*Reviewing the medical records attached to the claims such as doctor’s notes, nurse’s notes, Physical therapies notes &laboratory results, and diagnoses for proper reimbursement of medical services.
*Recommends if medical services provided are medically necessary or not (worker's compensation claims). 

4. Upgrade to see actual infoSantissima Trinidad Hospital of Daet | Staff Nurse 
*Identifies patient care requirements by thorough assessment; analyzes situations to anticipate pathophysiological problems &detect status changes. Documents patient care services by charting & maintaining the confidentiality of patients’ records. 

Upgrade to see actual infoAmerican International Group | Upgrade to see actual infoAmerican International Group 
*Medical Coding Review- ensuring that the descriptions of medical diagnoses & procedures are into the correct universal medical code numbers (ICD-9/ ICD-10/ HCPCS/ CPT).
*Associate the diagnosis codes with the appropriate procedure codes and sequence the codes in such a way as to ensure proper reimbursement.