Overview
Looking for full-time work (8 hours/day)
at $7.47/hour ($1,440.00/month)
Bachelors degree
Last Active
July 7th, 2026 (6 days ago)
Member Since
March 21st, 2025
Profile Description
Licensed Pharmacist with 5 years of experience across community and clinical pharmacy, currently working as a Pharmacist and Medical Virtual Assistant supporting U.S. medical insurance claims operations. Highly experienced in reviewing medical and pharmacy prior authorization tickets and providing clinical recommendations for approval, denial, or partial denial based on evidence-based guidelines and payer policies. Skilled in direct communication with U.S. physicians, nurses, and clinic staff to verify patient information and request additional chart notes to support accurate claim determinations. Proven collaborator working closely with U.S. pharmacists, physicians, and executive leadership to ensure regulatory compliance, clinical accuracy, and timely claim resolution.
Top Skills
Marketing » CRM » Microsoft Dynamics 365
Experience: 6 months - 1 year
Customer Support » Insurance » Prior Authorization
Experience: 6 months - 1 year
I review medical records and insurance requirements to ensure that medications, procedures, or treatments meet the payer’s criteria before approval. I verify patient eligibility and benefits, analyze chart notes to confirm medical necessity, submit prior authorization requests, and manage follow-ups, denials, and appeals while ensuring compliance with insurance guidelines.
Other Skills
Customer Support » Sales Support
Experience: 2 - 5 years
Office and Administration » Microsoft Excel
Experience: 10+ years
Customer Support » Customer Service
Experience: 5 - 10 years
Office and Administration » Communication
Experience: 5 - 10 years
E-Commerce » Product Research
Experience: 2 - 5 years
Customer Support » Healthcare
Experience: 2 - 5 years
I've worked as a Registered Pharmacist and Branch Supervisor in one of the top beauty and health retailer in Asia which is the Watsons Personal Care Inc. Also I've worked as an Inventory Custodian as well as a Pharmacist in one of the biggest aesthetic clinic in the country.
Office and Administration » Microsoft Word
Experience: 10+ years
Office and Administration » Microsoft Outlook
Experience: 5 - 10 years
Basic Information
- Age
- 28
- Gender
- Female
- Website
- Sign Up with Pro Account to View
- Address
- Salay, Misamis Oriental
- Tests Taken
- DISC
- Dominance: 50
- Influence: 20
- Steadiness: 16
- Compliance: 14
- English
- B2(Upper Intermediate)
- Government ID
- Sign Up with Pro Account to View
You have successfully pinned this profile! You can manage pinned profiles in your Employer dashboard.
Onlinejobs.ph "ID Proof" indicates if "they are who they say they are".
It DOES NOT indicate skill level.
ID Proof scores are 0 - 99 with 99 being the best. It is calculated based on dozens of data points.
It's intended to help employers know who they're talking to is real, and not a fake identity.