Raquel Paeste, Medical Insurance Coding Specialist

Raquel Paeste

Medical Insurance Coding Specialist

Suryana Medical Center

Lieu
Qatar
Éducation
Baccalauréat, Electronics and Communications Engineering
Expérience
16 years, 1 Mois

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Expériences professionnelles

Total des années d'expérience :16 years, 1 Mois

Medical Insurance Coding Specialist à Suryana Medical Center
  • Qatar - Doha
  • Je travaille ici depuis août 2016

Process insurance pre-approvals, billings and claim settlements.

Accountable for billing transactions and medical record keeping.

Customer Care Specialist à Concentrix Corporation
  • Philippines
  • juin 2014 à janvier 2016

Case handler of Savings and Investment Servicing of a UK-based bank which is a client of Concentrix.

Process customer's requests regarding their investments.

Technical Assistant à Chimei Innolux Corporation
  • Taiwan
  • mai 2011 à décembre 2012

Inspects and repairs all kinds of defects found in BM and RGB pixels of Color filters for LCD.

Health claims adjudicator à Manulife Financial
  • Philippines
  • juillet 2008 à mai 2011

Executes process and administer a broad range of financial transactions for Manulife Canada.
Maintains accurate record of business transactions and document analysis.
Adjudicate and process Claims within the agreed company SLA, clear to zero, in accordance with policy benefits to facilitate the company achieving its loss ratio target.
Ensure correct adjudication of claims thus allowing accurate reporting on claims data.
Operate within and meet the conditions of company service standards, clear to zero, to guarantee customer satisfaction and retention
Contribute to the team and departmental productivity targets so that the agreed SLA is achieved and a high level of customer service is provided.

BPO Associate/ Medical claims processor à Accenture
  • Philippines
  • avril 2006 à mai 2008

Process medical claims for a US - based Healthcare provider that is handled by Accenture. It involves analytical skills and good decision making on whether to submit or deny payments based on contracts and rules provided by the client for their subscribers.

Éducation

Baccalauréat, Electronics and Communications Engineering
  • à New Era University
  • mars 2005

The Bachelor of Science in Electronics and Communications Engineering is a 5-year college program which focuses on the conceptualization, design and development of electronic, computer and communication products, systems, services and processes. The BS ECE curriculum, built around a strong basic core of mathematics, physics and engineering, provides teaching and training activities in the classroom and in laboratory exercises. Subjects covered include communications device and networks systems, audio and video processing, radio and TV broadcasting, industrial electronics and instrumentation, integrated circuits design and more.It needs Analytical, Mathematical and Technical skills to succeed in these course.

Specialties & Skills

Administration
Analytical Skills
Document Analysis
Banking
Insurance Claims
Analytical/Research
Team Player
Interpersonal Skills
Computer Literacy
Can work with minimal supervision
Problem-Solving
Attention to details
Flexibility/Adaptability

Langues

Anglais
Expert

Formation et Diplômes

Understanding Antibribery Laws and Global business (Formation)
Institut de formation:
Accenture/online
Durée:
2 heures
Risk Management (Formation)
Institut de formation:
Concentrix
Durée:
1 heure
Data Privacy: What it means and Why it matters (Formation)
Institut de formation:
Accenture/online
Durée:
2 heures
Ethics and compliance - Confidential Protecting Assets and Information (Formation)
Institut de formation:
Accenture/online
Durée:
2 heures