Philippines
Medical Virtual Assistant Foreign Company | [November 2024] – [September 2025] • Provided comprehensive support to physicians and medical staff with administrative and clinical tasks. • Assisted with medical documentation, and maintaining accurate patient records. • Coordinated with patients for follow-ups, reminders, inquiries, and billing concerns. • Handled patient billing • Supported Revenue Cycle Management (RCM) by assisting with claims submission, payment posting, and denial follow-ups. • Performed back-office billing tasks, ensuring accuracy for billing the patient. • Conducted insurance verification and prior authorization assistance to prevent claim denials. • Adapted to various EMR/EHR systems and workflows with efficiency and accuracy. • Ensured confidentiality and compliance with HIPAA and organizational policies. Healthcare Associate – U.S. Healthcare Insurance (UHC) BPO Company | [October 2022] – [May 2024] • Handled inbound calls from U.S. healthcare providers regarding patient benefits and eligibility. • Assisted with prior authorization requests and ensured complete and accurate documentation. • Processed and followed up on claims inquiries, delivering timely resolutions. • Communicated clearly and professionally with providers on insurance policies and coverage. • Maintained compliance with HIPAA standards and company procedures. • Consistently achieved performance metrics, including call handling efficiency and quality assurance.
Verified patient insurance coverage and benefits. Book an appointment, cancellation and remind patient to their upcoming appointment. Coordinated with insurance providers to confirm eligibility, check authorization requirements. Input patients insurance coverage on template. Maintained compliance with HIPAA and clinic policies while handling sensitive patient information RCM Managed patient accounts by handling billing activities, ensuring accurate charges, and addressing account inquiries. Oversaw email management, responding to clinic correspondence regarding billing and account-related concerns. Processed refunds for overpayments and coordinated account adjustments as needed. Reviewed and closed patient accounts when no active inventory or services remained. Ensured proper documentation and compliance with company policies throughout the billing cycle.
Managing inbound calls from the provider. Providing benefit and eligibility information of the patient. Obtain and track prior authorization and appeal. Tracked patients whose claims were denied, still on process, underpaid, rejected or recoup. Guided providers through appeals, resubmissions, and correction processes as needed. Maintained detailed documentation of all claim interactions for compliance and auditing purposes. Explained claim determinations, insurance policies, and procedures in clear and professional communication. Delivered excellent customer service while balancing accuracy, efficiency, and empathy in high-volume calls