2014
AB Mass Communication
Pamantasan ng Lungsod ng Muntinlupa
More Info About Me
Energetic, goal-oriented, and able to diffuse stressful situation. Active listener, honest and trustworthy in a team setting, dedicated and hardworking individual. Poised, 5’7 inches in height, 28 yrs. old, confident and maintaining a cheerful attitude. Comfortable interacting with people from various cultures and backgrounds.
My Skills and Competencies
Data Entry
Content Creator
Social Media Management
Graphic Designer
Certificates
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My Experience and Education
2022
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2022
Timothy Groth MD PC (Remote Work)
(Authorization Specialist)
• Ensure that all assigned Authorizations are resolved within appropriate time restraints
• Research, follow-up, and resolve all open/pending Authorizations in a timely manner
• Contact Payors for status of outstanding/pending Authorization request
• Verifies patient insurance eligibility and benefits by means of Internet resources or manually procuring
information from the insurance carrier
• Conveys information regarding procedure codes and diagnostic codes in order to receive
correct referrals for office visits and authorization for outpatient procedures
• Communicates and coordinates with interdepartmental and interoffice personnel to procure correct and detailed information regarding all authorizations
• Updates and informs all parties involved of any insurance or procedural changes regarding authorizations or office visit referrals
• Obtains all authorizations for DME procedure and MRI out-patient procedures same day Identify primary and, as applicable, additional payers, based on established payer coverage guidelines and criteria
2019
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2022
Dexcom Inc.
(Patient Billing Specialist 2 | Finance)
•Responsible for verifying insurance coverage for Dexcom’s product offerings, including benefits,
eligibility, and coverage levels. Will are responsible for submitting prior authorization requests to insurance company and following up on all outstanding authorization requests until an outcome is determined. Act as a liaison between the Insurance Company, Regional Account Directors, Customer
•Operations Personnel, outside sales, and Patient Billing teams. Perform administrative functions
such as answering incoming calls and placing calls, participating in creating a sales team environment and in meeting and exceeding sales objectives.
•As a SME, I am managing escalations, expedite requests, turnaround time and quality review, vtraining, process overview.
2017
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2019
Optum (United Health Group)
(Recovery/Resolutions Sr. Analyst)
Recognize opportunities to identify and correct the issues that cause claims to be denied by insurers.
• Classify denials by reason, source, cause and other distinguishing factors.
• Develop and assess effective denial management strategies.
• Implement strategies that engage patients, referring physicians and others to effectively appeal and reverse unfounded denials.
Follows up on unprocessed or denied insurance claims through extensive phone, fax, and written correspondence with payors and pricing agencies. Works with physician offices and billing office employees to resolve any outstanding claim issues. Ensures correct reimbursement rates are paid on claims based on current client contracts. Utilizes knowledge of the revenue cycle and patient accounts to maximize reimbursements. Abides by and always promotes HIPAA compliance.
My Services
Social Media Management
Analyzing engagement data, identifying trends in customer interaction and planning digital campaigns to build community.
Data Entry / Web Researcher
Search the Internet for information on a wide variety of topics.
Content Creator
Promote companies' products and services by developing copy for websites, social media, marketing materials.