Patient Account Specialist

I have more than 10 years of experience in the BPO industry, and most of my experience is in handling healthcare accounts (back office, inbound, and outbound). I can perfectly handle accounts such as pharmacy, benefits and eligibility, claims, coordination of benefits, and accounts receivable, and I was even promoted to line trainer.

Claim investigation – follow up claims status to payers. Any rejected, underpayment, denied, pending claims should be corrected. To make sure we are paid according to our contract. If additional information needed like medical records, itemized bill, copy of approved authorization or appeal should be submitted in a timely manner to secure revenue. I also took in calls for claims status and inquiries why claim was denied and rejected.

Insurance verification of patients that is under infusion therapy done in home and facility by accessing insurance portals and outbound calls. Directly reporting to the client / Insurance Case Managers for patient related insurance concerns or updates. I also took in calls for Benefits and Eligibility verification for more than 5 years.

I called insurance to check if authorization is required for a specific service. I also check status if approved or denied and if denied I submit information that is needed and I send medical records and appeal. I also took in call to verify if authorization is required for providers.