Paul Ryan M. Cabansag

Contact #: *********

Email: ad0x00@r.postjobfree.com

VALUE

Provide exceptional output as a versatile Virtual assistant. I have 8 years of expertise in the U.S. healthcare industry which can help you exceed your goals. SKILLS/ AREA OF EXPERTISE

● HIPAA Trained

● Email and chat communication

● Inbound and outbound call handling

● Medical Billing and Coding

● Insurance Verification

● Prior Authorization

● Medical Records Management

● Advanced Excel

● Critical Thinking

● Adaptability

● Fast Learner

● Interpersonal Skills

● Flexibility

● Organizational Skills

● Time Management Skills

Tools

● Bluechip

● DME4DME

● Epic

● Kareo

● Integrated Management System (IMS)

● Avaya

● 3CX

● G suite

● MS Office

● Skype

● Zoom

● Team

WORK EXPERIENCE

July 2023 – PRESENT

Forta Health (Part-timer)

Insurance Verification, Prior Authorization & Medical Billing Specialist

● Checked client’s eligibility via Phone or portal.

● Checked if prior authorization for specific CPT code 97151,97153,97155, and 97156.

● Prepared Prior Authorization for Applied Behavioral Analysis (ABA) – Autism Spectrume client.

● Submitted the PA request to different insurance via Portal, Fax, Email, or Phone.

● Checked the status of submitted Prior Authorization.

● Updated our EHR to reflect the status of PA.

September 2022 - July 2023

Valley Medical & Wellness

Insurance Verification, Medical Billing & Prior Authorization Specialist

● Checked patient’s eligibility via Phone or portal.

● Prepared and submitted claims to different insurances accurately so that the necessary payments can be collected in a timely manner.

● Checked the status of claims that were previously submitted to see denied or no response claims and take necessary actions.

● Submitted appeal on denied claims on different insurances via portal, fax, or email to avoid delay on patient’s medications or services.

● Checked insurance eligibility for potential new patients prior to the Patient Scheduling team scheduled the patient for an appointment.

● Initiated new, renewal, and quantity limit request for prior authorization via Covermymeds, Fax, or Phone for the patient’s medication to immediately provide proper care that the provider thinks is the best for them.

● Created standard work instruction (SWI) for their medication refill request, sending PA request, and Medical Billing process so that new hires will be easily familiarized with the workflow. This also serves as a cheat sheet for the tenured to eliminate process gaps.

July 2022 - September 2022

Alba Medical & Supplies

General Medical Virtual Assistant

● Checked patient’s eligibility via Phone or portal.

● Checked if prior authorization is needed for different DME products.

● Delegated for claims submission, making sure all necessary claims supporting documents were attached, or completed prior sending to insurances. By doing this it will lessen the claims denial so that the time of other resources can be allocated to other tasks.

● Helped them create process flow guidelines that can be used by their current and future VAs on their day-to-day tasks. This document eliminates skipped and missed on their standard process flow.

February 2021 - June 2022

Willis Towers Watson

U.S healthcare Reports Analyst, Data analyst & Reporting

● Collected data on different insurance portals to create reports that will be used to help client’s company analyze their healthcare expenses and project budget and cost for the following year. These reports also helped them choose appropriate healthcare benefits that can be offered to client’s employees.

● Helped our U.S. counterpart actuaries lessen their burden on creating excel reports so that they can focus on client’s specific needs and wants. December 2018 - January 2021

Accenture, Inc/Blue Cross Blue Shield of TX, IL, OK, MT, NM Service Delivery Operation Analyst (Team Lead)

● Led team of 15-20 Claims Data Analysts. Make sure that the team metrics and expectations are met.

● Did client presentations for the project’s performance.

● Managed the daily operations of the team and account. September 2016 - December 2018

Accenture, Inc/Blue Cross Blue Shield of TX, IL, OK, MT, NM Transaction Processing Associate (Subject Matter Expert)

● Tasked to support a team of 15-20 Claims Data Analysts. Methodically answered their questions and inquiries with regards to the account's processes.

● Managed team quality. Ensured that every transaction followed standard procedures.

● Discussed process updates to avoid penalties that company may occur due to incorrect claims determination or processing.

● Developed team process strategies to maintain quality of every transaction. June 2015 - September 2016

Accenture, Inc/Blue Cross Blue Shield of TX, IL, OK, MT, NM Transaction Processing New Associate (Claims Data Analyst)

● Entrusted for determining if claims submitted by different Hospital, Clinic, or Provider will be paid or denied.

EDUCATION

Far Eastern University

Bachelor of Science in Information Technology

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