Medical Virtual Assistant | Patient Billing & Insurance Expe

Member Service Representative | Concentrix | 2019 – 2024 Resolved member inquiries on eligibility, claims, and benefits. Assisted with enrollment, billing, and account updates. Educated members on plan policies and resources. Provider Service Representative | Quezon City | 2019 – 2024 Liaised with providers and insurers to resolve claim denials and billing issues. Tracked and resubmitted claims (CMS-1500, UB-04). Trained staff on CRM, data accuracy, and claim tracking.

Responsible for ensuring that claims are submitted accurately and in a timely manner, so that healthcare providers can receive payment for their services. We deal to multiple professionals who seek advice how to submit claims. Reviewing their information to verify insurance coverage, eligibility, and if there is pre-authorization needed from our client to provide the physical therapy services they offer. Reviews medical records, schedule patient appointments, and perform other admin tasks and routine office duties. Helping customers of one of the famous insurances in Amerika (Anthem BCBS). Providing excellent services by customer inquiries, both telephonically and by email, Managing large amounts of inbound and outbound calls in a timely manner. Identifying customers’ needs, clarify information, research every issue and provide solutions answering inquires WHILE ON multiple chats. Experience in claims and denials Trained in insurance verification, claim submission, insurance authorizations, medical billing, answering patients’ questions about their accounts, and advising to where they should submit claims correctly. Managing incoming calls and customer service inquiries Generating sales leads that develop into new customers Identifying and assessing customer needs to achieve satisfaction Maintaining a positive, empathetic, and professional attitude toward customers Responding promptly to customer inquiries Communicating with customers through various channels Acknowledging and resolving customer complaints

Medical Virtual Assistant | Remote | 2024 – 2025 Managed patient intake, referrals, pre-authorizations, and medical records. Scheduled appointments and verified insurance eligibility. Processed insurance claims, appeals, and liaised with providers/insurers. Tools: Office Ally, Kareo, AdvancedMD, eClinicalWorks, NextGen, Salesforce. Insurance handled: Cigna, UnitedHealthcare, Medicaid, Medicare, Aetna, BCBS, Tricare, Workers’ Comp.

Responsible for communicating with consumers through a company’s chat support feature. Their key responsibilities include Providing timely and accurate responses to customer inquiries via chat support platforms. Assisting customers with product information, technical support, and issue resolution. Maintaining a professional and courteous demeanor while interacting with customers. Documenting customer interactions and feedback for analysis and improvement purposes.

Managed billing, collections, insurance claims for diverse patient profiles Processed prior authorizations and claim appeals Scheduled appointments and provided telehealth support Explained insurance plans, deductibles, co-pays to patients Handled confidential information with professionalism and HIPAA compliance Liaised with insurance reps and patients to resolve payment issues

Skilled in medical credentialing, including provider enrollment, document verification, payer communication, regulatory compliance, and managing credentialing systems with accuracy and efficiency.