Nikkimark

Insurance Eligibility Verification Specialist

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Overview

Looking for any work (8 hours/day)

at $5.30/hour ($1,024.00/month)

Bachelor's degree

Last Active

June 29th, 2026 (10 days ago)

Member Since

May 22nd, 2026

Profile Description

I am a Medical Virtual Assistant specializing in insurance eligibility verification with over 9 years of combined experience in the BPO and healthcare support industry. My background includes 5+ years managing UMR insurance processes, 4+ years in Workforce Management/Real-Time Analysis, and a billing internship that strengthened my knowledge of claims and patient account workflows.

My expertise lies in verifying patient coverage, ensuring accurate benefit checks, and supporting providers with eligibility-related tasks to reduce claim denials and delays. I am highly detail-oriented, deadline-driven, and committed to maintaining HIPAA compliance while handling sensitive patient information.

I am proficient in EMR/EHR systems, Microsoft Office, and Google Workspace, and I bring strong communication skills to liaise effectively with patients, providers, and insurance representatives. My goal is to help healthcare organizations streamline eligibility verification processes, improve accuracy, and deliver reliable administrative support.

Top Skills

Customer Support » Insurance » Prior Authorization

Experience: 2 - 5 years

Managed prior authorization inquiries — confirming PA requirements, checking auth status, advising on submission methods, and communicating standard (3–5 day) and expedited (72-hour) review timelines.

Customer Support » Insurance » Insurance Verification

Experience: 2 - 5 years

Handled eligibility and benefit verification inquiries — confirming active coverage, deductibles, copays, coinsurance, OOP maximums, visit limits, and exclusions across diverse employer group plans.

Professional Services » Medical Services » HIPAA Compliance

Experience: 2 - 5 years

Documented all interactions in internal CRM systems with audit-ready precision — reason, outcome, reference number, and follow-up tasks — in compliance with UMR quality and HIPAA standards.

Other Skills

Professional Services » Medical Services » Medical Billing

Experience: 2 - 5 years

Managed denial queues by interpreting remark codes, identifying root causes, and executing the correct resolution: billing correction, adjusted resubmission, or formal written appeal with medical records attached. • Submitted corrected claims and formal appeals with supporting clinical documentation through Availity and direct payer portals.

Basic Information

Age: 32

Gender: Male

Website: Sign Up with Pro Account to View

Address: Cebu, Cebu

Tests Taken: IQ
Score: 98: DISC
Dominance: 2
Influence: 10
Steadiness: 51
Compliance: 37: English
C1(Advanced)

Government ID: Sign Up with Pro Account to View

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