Medical Virtual Assistant & Administrative Support | Customer Service

Served as a secondary case reviewer (“Sweeper”) responsible for handling denied or disputed provider cases by conducting thorough research and reviewing all related documentation. Analyzed the reason for case denial, verified eligibility details, benefits information, and claim data to determine whether the case qualified for reconsideration. Gathered and validated additional supporting information before resubmitting cases to reviewers, ensuring accuracy, completeness, and compliance with healthcare guidelines. Coordinated with internal teams to clarify discrepancies and strengthen case justification prior to escalation. Maintained strict adherence to HIPAA regulations and quality assurance standards while ensuring timely and accurate case resolution.

Assisted U.S.-based cardholders with billing inquiries, payment disputes, and fraud investigations, ensuring accurate and timely resolutions. Managed high-volume inbound and outbound calls while maintaining professionalism and compliance with financial regulations. Processed account adjustments, fee reversals, and payment arrangements with precision and attention to detail.

Assisted healthcare providers with insurance eligibility verification, benefits review, prior authorizations, and claims status inquiries. Resolved complex healthcare concerns using HIPAA-compliant communication while maintaining professionalism and empathy. Served as a “Sweeper,” reviewing and validating disputed claims to ensure accuracy, compliance, and proper resolution. Consistently met and exceeded KPIs for quality assurance, call handling time, and resolution efficiency.

Dedicated healthcare professional transitioning into a Medical Virtual Assistant role, leveraging hands-on experience supporting healthcare providers with insurance verification, claims validation, and authorization processes. Developed a strong understanding of medical terminology, insurance workflows, documentation accuracy, and HIPAA-compliant confidentiality standards. Proven ability to manage high-volume inquiries, maintain quality assurance benchmarks, and exceed performance metrics while delivering professional and empathetic communication. Skilled in administrative support, system navigation, and compliance-driven processes. Highly organized, detail-oriented, and adaptable, with the ability to work independently in remote environments while ensuring operational efficiency and reliable client support.