Pre Authorization/Callcenter
Pentacare Medical Services
مجموع سنوات الخبرة :16 years, 10 أشهر
• On process of getting medical coding certificate.
• Trained with PBM provided by MEDIMPACT.
• Knowledgeable with CPT’s, ICD9 and ICD10.
• Customer-service oriented.
• Answering requests through phone, email and fax.
• Trained in encoding claims through AMAN Insurance Management System.
• Managing requests accurately and efficiently.
• Can work under pressure.
• Eyeing on details and providing correct information regarding the policies of
every client.
• Flexible when it comes to scheduling.
• Goal-oriented, team player.
• Attended ISO 9001:2008 regarding management skills and improvement.
• In Charge for communication and approvals of Gulf ASSIT / Afro Asian claims (Internal TPA members).
• Minimize fraud by conduction of provider visits, second opinions and profiles.
• Maintain documentation process in relation to providers.
• Familiar with the table of benefits of the medical insurance.
July 2007 - Present Computer Technician
• Computer Reformatting using Windows Operating System and troubleshooting Boot and Compatibility problems.
• Troubleshooting computer softwares like Anti-virus, Microsoft Office, Sound drivers, Video drivers, Printer softwares.
• Troubleshooting computer hardwares like Video card, Sound card, RAM, Motherboard, PC Monitor, Printer, Processor, USB.
Clinical Experience
Angeles Medical Center, Inc. Angeles City
* Assigned in the Operating Room, Emergency Room, Main, East Wing, Annex, and Executive Wards
* Exposed in the Intensive Care Unit, Hemodialysis Unit
Balitucan District Hospital Magalang, Pampanga
* Assigned in the Operating Room
Diosdado P. Macapagal Memorial Hospital Guagua, Pampanga
* Assigned in the Operating Room
Escolastica Romero District Hospital Lubao, Pampanga
* Assigned in the Delivery Room
Jose B. Lingad Memorial General Hospital City of San Fernando, Pampanga
* Assigned in the Emergency Room, Operating Room, Obstetrics, and Medicine Wards
Porac District Hospital Porac, Pampanga
* Assigned in the Operating Room, Delivery Room, and Main Ward
Saint Raphael Foundation Medical Hospital Dau, Mabalacat, Pampanga
* Assigned in the Operating Room
Seminars Attended
July 2013 - January 2014 Back-Office Support Staff
Microtel Global Solutions Incorporated
➢ Duties and Responsibilities:
• Encoding bills on data base.
• Creating a packet for a bill.
• Cleaning-up data of each patient.
• Posting of payments
➢ Knowledgeable on Medisoft, Raintree, Eclipse, and Scandox Softwares.
April 2011 - May 2013 Private Duty Nurse
Cerebro-Vascular Accident Patient (Left-side Paralysis)
➢ Duties and Responsibilities:
• Bathing the patient.
• Assisting patient on daily exercises and therapies.
• Moving patient with proper techniques. (wheelchair-bed vice-versa)
• Changing dressing of PEG tube.
• Administering medications.
• Assisting patient while eating.
Rehabilitation Nurse - provides direct care and counseling services to people who suffer from physical and mental disabilities, chronic illnesses, or substance abuse problems. He or she helps people re-establish independent lifestyles after debilitating incidents. A rehabilitation nurse also educates family members and caregivers about an individual's disability and how they can provide the best support.
The goal of a rehabilitation nurse is to help a recently disabled or ill person regain a high degree independence. Nurses help people adjust to difficult circumstances involving their home life, job, and interactions with family and friends. They provide constant encouragement and suggest strategies to help people adapt to their disabilities.
*knowledgeable with Physical and Occupational Therapy Techniques.
November 2010 - January 2011 Collection Specialist (Trainee)
Microtel Global Solutions Incorporated
➢ Duties and Responsibilities:
• Doing pre-collection.
• Obtaining information about the adjuster for a claimant.
• Making sure the data input are accurate.
Tertiary: 2006-2010 Holy Angel University Angeles City Bachelor of Science in Nursing Secondary:
2001-2005 Don Bosco Academy Mabalacat City High School Graduate (with special awards) Primary:
1993-2001 Narciso School Incorporated Angeles City Elementary Graduate
