Ma. Romina B. Dominguez
Al Nahda 2 Dubai, UAE
HIGHLIGHTS OF QUALIFICATIONS
• 10-year experience in healthcare insurance industry with ICD 10, CPT-10, & Medical Terminologies.
• Good knowledge of medical and insurance rules and regulation.
• In-depth knowledge of healthcare operations
• Complete insurance and other claim forms.
• In depth knowledge of insurance policies and claims (resubmission and submission) and pre-authorization policies
Excellent Data Entry with speed type of 40-45 wpm.
SUMMARY OF RELEVANT SKILLS
• Computer Skills (MS Word, MS Excel and various processing system)
• Communication Skills (Written and Verbal)/ Telephone Etiquete
• Organizational and Clerical Skills
• Schedule and confirm appointments
• Customer Service Skill
• Ability to work independently and in cooperation with other
Received Peak Performer Award on 2018 (NTT Data Services – Dubai Hospital (Government Hospital)
Received Peak Award on 2010 - (Almadallah Healthcare Management)
1. Admission and Medical Billing Officer December 2019 - present
Clemenceau Medical Centre
Al Jadaf, Dubai, United Arab Emirates
• Perform various admin functions such as data entry, scheduling, admitting and discharging patient etc
• Provide informed financial consent and collect payments where needed.
• Answering all patient or insurance telephone inquiries, schedule medical appointments, inform patient and medical staff.
• Checking eligibility and benefits verification for treatments, hospitalizations, and procedures
• Entering patients into computer system with demographic and insurance information, as necessary.
• Responsible for entering charges in as accurate a manner as possible, which means coordinating with the doctor's office to obtain any missing information (i.e., insurance cards, authorizations, op reports, etc.)
• Getting approval and checking validity if th services requires authorization.
• Verify if the interim invoice is billed accurately in accordance to insurance terms and condition.
2. Senior Medical Coordinator …… .. January 2017 -October 2019
NTT Data Service outsourcing Dubai Health Authority (Government entities)
Burj Al Salam, Sheikh Zayed Road Dubai UAE
• Coordinating, liaising and networking between insurance companies regarding eligibility, approvals, and other requirements.
• In-charge in obtaining OP and IP approval request along medical reports with CPT and ICD 9 or 10 codes to insurance companies through email, online entry or, and as well as taking verbal approval for urgent or emergency cases.
• Answered all patient telephone inquiries regarding their bills and insurance questions.
• Performs receptionist duties by receiving telephone calls, patients/clients, visitors, and others, answers inquiries or directs to appropriate area or staff.
• Performs clerical duties as required such as typing, record keeping and ordering supplies, entering and retrieving computerized data and patient/client information, and sorting and distributing mail.
• Provide a variety of reception services by answering telephones, operating multi-line switchboard, booking appointments and registering new clients.
• Complete insurance and other claim forms,
3. Associate Denial Management Analysis October 2014 – November 2016
Accumed Practice Management
Jumeirah Lake Tower, JLT Dubai
• Communicate with insurance companies in behalf of our client to determine denial reasons and any criteria for resubmission of claims.
• Responsible for knowledge of all contract and coverage guidelines.
• Coordinate with doctors related to medical record of patients & identified
causes of rejection & notified the same to the concerned departments
• Assess and process rejected medical claims for resubmission purposes.
• Properly process and audit all type of claims received by our clients (hospitals, medical centre, clinics), from the medical and insurance perspective.
4. Medical Claim Processor September 2009 – October 2014
Almadallah Healthcare Management
Dubai Academic City, United Arab Emirates
• Process and diagnose confidential patient conditions using examinations and tests based on medical findings; their prescribed treatment and medications
• Updates priority lists on a daily basis to determine which batches of claims needs to be evaluated and processed first to meet cheque due dates.
• Performs evaluator/doctor functions when physician is out of the office. Evaluates and process payment of insurance claims and determines whether or not to compensate such claims.
• Enter or process claims in the system with speed type of 40-45 wpm.
Bachelor of Science in Chemistry 2000 – 2004
Cagayan State University, Carig Campus, Cagayan
Bachelor of Science in Nursing 2000 – 2007
Medical College of Northern Philippines, Alimanao Hills Penablanca Cagayan
Certificate in Medical Coding (CPC) 2016 – 2016
Al Talouk Medical Training Centre
REFERENCE AVAILABLE UPON REQUEST