Medical Authorization Executive
Neuron LLC
مجموع سنوات الخبرة :17 years, 6 أشهر
• Verifies the enrolment status of claimant, at the same time, inspecting all claim documents.
• Implements fixed policies prearranged by the insurance companies catering to members individually and by group.
• Required to give pre-authorization approvals to hospital providers who need any medical services, such as: IN-PATIENT / OUT-PATIENT / OPTICAL / DENTAL / PHARMACY, for eligible members of a specific insurance company.
• Coordinates with medical provider for verification of documents and wherever additional information is required to assess medical requests properly before giving out any approvals for any procedure or prescription.
• Confer and relay with members any updates / revisions made by their respective insurance companies.
• Effectively assessed and processed claims/ e-claims medically, correlating diagnosis with procedures, tests and prescribed medicines as per Table of Benefits per Insurer.
• Attends claims queries, by updating the insured person/ broker regarding the status of the medical claims submitted
• Easily adapts to change and requires less supervision especially when proper training has been given.
NEURON LLC - Medical Authorization Executive - Helpline
.6th Floor IT Plaza Bldg, Dubai Silicon Oasis Authority, Dubai, UAE, 72071
March 2012 - Present
• Verifies the enrolment status of claimant, at the same time, inspecting all claim documents.
• Implements fixed policies prearranged by the insurance companies catering to members individually and by group.
• Required to give pre-authorization approvals to hospital providers who need any medical services, such as: IN-PATIENT / OUT-PATIENT / OPTICAL / DENTAL / PHARMACY, for eligible members of a specific insurance company.
• Coordinates with medical provider for verification of documents and wherever additional information is required to assess medical requests properly before giving out any approvals for any procedure or prescription.
• Confer and relay with members any updates / revisions made by their respective insurance companies.
• Effectively assessed and processed claims/ e-claims medically, correlating diagnosis with procedures, tests and prescribed medicines as per Table of Benefits per Insurer.
• Attends claims queries, by updating the insured person/ broker regarding the status of the medical claims submitted
• Easily adapts to change and requires less supervision especially when proper training has been given.
- Delivers direct patient care: assesses patient’s physical, psychosocial, and/or emotional needs: provides patient family teaching: triages patients and informs physician of patient status: responds to phone messages from patients and informs physician as needed.
- Administers medications as assigned: serves as a resource person for knowledge of medication uses, side effects, and dosage; checks for proper medication order; documents medications; obtains required consent forms to administer immunizations; notifies pharmacies of physician approved prescription; reviews drug samples to insure that they have not exceeded the expiration date; labels sample drugs and educates patients of medication administration.
Pasay City General Hospital - Staff Nurse
Pasay City Sept. 1, 2006 - Sept. 30, 2007
- Delivers direct patient care: assesses patient's physical, psychosocial, and/or emotional needs: provides patient family teaching: triages patients and informs physician of patient status: responds to phone messages from patients and informs physician as needed.
- Administers medications as assigned: serves as a resource person for knowledge of medication uses, side effects, and dosage; checks for proper medication order; documents medications; obtains required consent forms to administer immunizations; notifies pharmacies of physician approved prescription; reviews drug samples to insure that they have not exceeded the expiration date; labels sample drugs and educates patients of medication administration.
- Delivers direct patient care: assesses patient’s physical, psychosocial, and/or emotional needs: provides patient family teaching: triages patients and informs physician of patient status: responds to phone messages from patients and informs physician as needed.
- Administers medications as assigned: serves as a resource person for knowledge of medication uses, side effects, and dosage; checks for proper medication order; documents medications; obtains required consent forms to administer immunizations; notifies pharmacies of physician approved prescription; reviews drug samples to insure that they have not exceeded the expiration date; labels sample drugs and educates patients of medication administration.
Bachelor of Science in Nursing
2002 - 2006 Catanduanes State Colleges College of Nursing and School of Midwifery, Virac, Catanduanes Bachelor of Science in Nursing CHED Special Study Grant Program for Congressional District (Scholar)
1998 - 2002 Catanduanes State Colleges Laboratory High School, Virac, Catanduanes High School Diploma
1992 - 1998 Catanduanes State Colleges Elementary Laboratory School, Virac, Catanduanes Elementary Diploma