Patient Administrator
Mediclinic City Hospital
Total years of experience :11 years, 1 Months
o Provides information in response to queries about the Hospital's services, and handles and resolves patient complaints
o Manages and schedules doctors' appointments via the Hospital Information System
o Directs patients and visitors to appropriate areas in the Hospital
o Handles telephone calls and messages; assists callers by providing necessary information about the hospital.
o Register, check in patient’s clinic appointment.
o Inform patient of Insurance Approval status and coverage.
o Check insurance eligibility and coverage for patient
o Collect/ refund payment if needed.
o Process insurance billing depending on patients coverage
o Request insurance approval if needed
• Senior Customer Service Specialist
United Health Group
August 2012- July 2013
o Floor Support, Assisting new hires in proper handling of call and claims
o Handles clients call inquiries, request and concern in timely fashion
o Quote Table of benefits to provider/ doctors.
o Process medical claims based on how the plan is designed
o Informing provider what specific information needed to process claims.
o Communicates clearly and efficiently with clients customers
o Constantly meet established productivity, schedule adherence, and quality standards
o Ensures compliance of transactions to applicable U.S. laws, rules and regulations
o Accurately documents all provider interactions according to procedure
o Providing assistance to Providers with claim status updates and payment
o Responsible for any follow-up work needed for resolving and closing issues
o Identifying and resolving anticipated client issues to prevent future calls
o Maintain proficiency in all technical applications (technical skills and system knowledge)
o Consistent Account's TOP PERFORMER
o UHG STAR AWARDEE (Highest Overall Performance Across UHG Metrics 2012)
• Customer service Representative
APAC Customer Services Inc - Manila, Philippines
October 2010- August 2012
o Part of the elite Incubated Group that handles sensitive client call/ or escalated call
o Protect confidential personal information in all transactions
o Ensuring accurate information provider member and providing one time call resolution
o Processes enrollments and terminations.
o Processing and checking status of order
o Explaining coverage design and assisting member on how to maximize their prescription benefits
o Checking billing statement and processing payment
ACHIVEMENTS: o Consistent Account's Top Performer
o Consistent Call Quality Champion
o Account's Finest Agent
o Account's WOW BLACK BELTER Awardee
Tertiary: Arellano University 2008-2009 Bachelor of Science in Nursing Pasay City
Adamson University 2005-2008 Bachelor of Science in Nursing Malate, Manila