Overview
Looking for full-time work (8 hours/day)
at $4.14/hour ($800.00/month)
Bachelors degree
Last Active
July 6th, 2026 (3 days ago)
Member Since
September 1st, 2025
Profile Description
Overpayment Handling: Validate setup and reasons (duplicate, COB, fee schedule), verify claims (paid vs. allowed), determine recovery method (refund or recoup/offset), track timelines, document, and follow up until resolved.
Appeals & Documentation: Confirm appeal receipt and level, review attached clinical/claim documents, track workflow stage, and request missing records via secure channels.
Claim Lifecycle Management: Monitor claims from receipt to payment/denial, ensure proper documentation (EOBs, notes), and attach all records for reprocessing or appeal review.
Customer Service: Handle inbound inquiries professionally, resolve issues on first contact when possible, escalate complex cases, maintain clear communication, and ensure customer satisfaction through follow-ups.
Collaboration & Performance: Share best practices, contribute to process improvements, and support teammates; recognized for high-quality, customer-focused performance.
Resolution & Communication: Identify fixes (corrected claim, docs, overrides), provide clear case summaries (dates, billed vs. allowed, adjustments), and send EOB/ERA securely with reference numbers, next steps, timelines, and compliance disclosures.
Top Skills
Customer Support » Healthcare
Experience: 1 - 2 years
Customer Support » Insurance » Medical Insurance
Experience: 1 - 2 years
Work in various medical Insurances. Have an extensive knowledge on healthcare insurance policy and terminology.
Professional Services » Medical Services » Patient Care
Experience: 1 - 2 years
Assisted members/patients with their concerns by explaining their insurance policies, scheduling appointments, addressing billing issues, demonstrating empathy, and going above and beyond
Other Skills
Customer Support » Phone Support » English Speaking
Experience: 1 - 2 years
Handling US Healthcare accounts.
Customer Support » Customer Service
Experience: 1 - 2 years
Work as a costumer service representative handing inbound and outbound calls. Provide excellent costumer service to the provider and the member.
Professional Services » Medical Services » HIPAA Compliance
Experience: 1 - 2 years
Trained to abide HIPPA compliance as part of my role as a customer service representative handling Healthcare accounts.
Basic Information
- Age
- 25
- Gender
- Male
- Website
- Sign Up with Pro Account to View
- Address
- Lila, Bohol
- Tests Taken
- IQ
- Score: 102
- DISC
- Dominance: 38%
- Influence: 17%
- Steadiness: 20%
- Compliance: 25%
- English
- C1(Advanced)
- 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.