Anjelo James Galvez, Call Center executive

Anjelo James Galvez

Call Center executive

Pentacare Medical Services

Location
United Arab Emirates - Dubai
Education
Bachelor's degree, BS Nursing
Experience
10 years, 6 Months

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Work Experience

Total years of experience :10 years, 6 Months

Call Center executive at Pentacare Medical Services
  • United Arab Emirates - Dubai
  • My current job since January 2015

• Gathers and process all the information needed to complete the medical insurance claims.
• Taking inbound costumer service calls and making outbound calls to the patients and healthcare providers.
• Analyzing all information gathered before giving approvals or rejections accordingly on every claim with prior consultation to the pre-approval manager.
• Monitoring the limits of each member’s before giving approval for a particular claims such as the preexisting limit, chronic limit, pharmacy limit etc.
• Refers questionable claims to the manager, investigating pending claims and resolve discrepancies.
• Proficient in processing medical claims using the Aman Insurance System Software, familiar in using ICD’s & CPT codes and online prescriptions thru PBM Software provided by MedImpact.

claims encoder, reimbursement encoder and clerk at Intellicare
  • Philippines
  • October 2013 to November 2014

Education

Bachelor's degree, BS Nursing
  • at Bulacan State University
  • April 2011