Nurse Practitioner

§ Proficiency with Microsoft office applications such as MS Word, Excel and PowerPoint

§ Ability to work independently

§ Excellent skills in analyzing legal documents and medical records

§ High problem-solving and organizational skills

§ Attention to details towards management protocol

§ Highly knowledgeable in administrative task such as assisting calls, operating photocopier, scanner & fax machine

Medical Claims Officer/ Reconciliation/Claim Processor Almadallah Healthcare Management FZ. LLC. (OCTOBER 2009 - OCTOBER 2018) Dubai International Academic City Blk. 3 Rm.8

§ Updates a priority list every day on which batches needs to be evaluated and processed first to meet the due dates.

§ Responsible for all the queries of providers regarding the discrepancies due to partially approved or rejected claims.

§ Prepares the batches that are for payment.

§ Responsible for the claims report for the accounts.

§ Sends weekly report to Head of claims, Accounts Supervisor and Head of Network.

§ Prepares common terminology and upload it in the system.

§ Conduct training upon request (if there are new processors).

§ Provide Customer Service, such as giving limited instruction on how to proceed with claims or and provide claims status for Network Providers.

§ Correlate information with the manager for any problems arises in the day.

§ Knowledge of Administrative and Clerical procedures and systems such as word processing, managing files and records, and transcription designing forms and other office procedures required.

§ Claims Processor responsibilities also apply (Direct claims/Resubmissions/E-claims/Re- Imbursement claims).

§ Check the cut-off report from time to time to check priority batches and to see the updates and status of the claims.

§ Update the processor’s regarding due batches to be finished for a day. A N N E M U R R H E L L E

M A S I C A T C A L I N I S A N

Address: 342 Karunungan St. Balakilong, Laurel,

Batangas.

Email:**.*********@*****.***

/***********@*****.***

Contact no.: 097********

C O R E Q U A L I F I C A T I O N S

O B J E C T I V E

W O R K E X P E R I E N C E

Driven individual with 10 years of experience as an insurance professional seeking for an employment that will elevate my strength and skills in the best interest of the company.

§ Check and filling-up the boxes for processing.

§ Arranging the evaluated claims by its due date.

§ Check the claim if entered correctly.

§ Check the claim action (approved, partially paid, rejected, true or false).

§ Do some editing if needed, after editing make reconciliation report.

§ Scanned the partially paid & rejected claims and save it in a CD to be given to accounts together with the letter for the provider and uploading the scanned files in the system.

§ Attending phone calls and e-mails if needed (normally from the provider). RECEPTIONIST/CALL CENTER (SEP 2008 – SEP 2009)

NMC SPECIALITY HOSPITAL

Al Nahda Dubai, UAE

§ Request, collects, sort and prepare medical / patient’s file from MRD for appointment patients.

§ Prepare different insurance claim forms to go with the files and arrange them in the respective doctor’s chambers.

§ Maintains confidentiality of the files at all times.

§ Cater to the needs of the all incoming patient’s (with or without appointments).

§ Registration of new patients to include the explanation of the patient and family bill of rights and responsibilities.

§ Record incoming messages of the doctors.

§ Booking appointments and entertaining queries through the multi-line switchboards system.

§ Participates in the monthly staff educational conferences. COMMUNITY HEALTH NURSING (February 5 – March 14, 2007) Bgry. Gonzalez Tanauan City, Batangas, Philippines

§ Do a survey to have complete data of the community

§ House to house visitation to check every family’s health status

§ Do Health teaching in school and to the people of the community

§ Do Health project’s in the Community to help the people of the community maintain their health and cleanliness of the surroundings

NATIONAL CENTER FOR MENTAL HEALTH (October 23-27, 2006) Mandaluyong City, Philippines

§ Guide and teach the patient about the activity for the day

§ Making schedules of activities for the whole week to make them aware for what they are going to do for the week

§ Teach them livelihood activity

§ Orienting the patient about reality

§ Guide them in having good hygiene

§ Health teaching

§ One on one interview with the patient

§

ORTHOPEDIC CENTER HOSPITAL (February 13-24, 2006)

Quezon City, Philippines

§ Ward nurse

§ Do health teaching

§ Guide patient upon having proper hygiene to prevent further infection

§ Taking their vital signs

§ Giving them support to help them to recover

§ Do nursing care plan

§ Have case presentation to understand the situation of the patient and its diagnosis SAN LAZARO HOSPITAL (January 2 – 13, 2006)

Santa Cruz, Manila, Philippines

§ ward nurse

§ Have case presentation

§ Do rounds to check every patient

ON THE JOB TRAINING

§ Take vital signs

§ Administer medication

§ Do NCP

§ Change IV

§ Change bed sheets

§ Health teaching

§ Take personal information of the patient

§ Study their case

DANIEL MERCADO MEDICAL CENTER (January – October 2006) Tanauan City, Batangas, Philippines

§ September –December 2005 take vital signs

§ Assist the patient

§ Take personal records of the patient

§ Health teaching

§ Case presentation

§ Assist the delivery of the mother & a new born baby

§ Assist in the operation in the Operating room

§ Assist in the minor case

§ Give medication

§ Change IV’s

§ Check urine output

§ Have rounds to check the patient

§ Endorse the patient to the next duty

§ Make NCP

§ In OPD we check the record of the client and check their vital signs

§ Send specimen in the laboratory

§ Send pt. In the X-ray

§ NGT feeding

§ Feeding the newborn and monitor their condition in the ICU

§ Cut cords of the baby

§ Give vaccines

§ Do injections like IM, SC

§ Insert IV

§ Assist in dialysis unit

§ Patient’s tagging

PRIVATE INSTITUTION FOR MENTAL HEALTH (January 2-6, 2006) Mandaluyong City, Philippines

§ Interview & orient the patient

§ Give them activities

§ Teach them livelihood projects

§ Give their medications

§ Teach them to have proper hygiene

§ Make schedule for the activities for the week to make them aware and participate

§ Attends the need of the patient

LAUREL DISTRICT MEMORIAL HOSPITAL (August 22-31, 2005) Batangas City, Philippines

§ OPD nurse interview patient about their personal information

§ Take their vital signs

§ Give them medications

§ Health teaching like family planning, dengue, malaria, tuberculosis etc.

§ Do Leopolds maneuver to pregnant mothers

§ Compute their EDC/ expected date of confinement

§ Assist upon delivering the baby

§ Cut the cord

§ Give vaccines

§ Count baby’s heartbeat

RURAL HEALTH UNIT (August 1-17, 2005)

Tanauan City, Batangas, Philippines

§ Take patient personal record and information

§ Take their vital sign

§ Give them medication and vaccines

§ Do Leopold’s maneuver

§ Assist RHU physician upon examining the pt.

§ Do health teachings

§ Take weight and height of the pt.

§ Case study

BATANGAS REGIONAL HOSPITAL (June 26-July 27, 2005 & January 9-August 2006) Batangas City, Philippines

§ Ward nurse

§ Take vital signs

§ Make rounds to every patient’s room

§ Health teaching

§ Teaching proper hygiene

§ Make NCP

§ Administer medications

§ Assist in the delivery room

§ Assist in the new born baby like cutting the cord, bathing measuring, weighing etc.

§ OPD Nurse take personal records of the patient and their v/s and guide them upon going to the clinic

§ Case study

§ Change IV

§ Tagging of patient

§ Attends the need of the patient

T E R T I A R Y

DMMC Institute of Health Sciences Tanauan City, Batangas Bachelor of Science in Nursing June 2003 – April 2007 S E C O N D A R Y

La Consolation College Tanauan City, Batangas

June 1999 – March 2003

§ Employee of the Month First Quarter of 2011 (Almadallah Healthcare Management FZ LLC)

§ Medical Coder Field of Study ICD, CPT coding HCPCS (October 2015- March 2016) Al Talouk Medical Training Center

§ Customer Service Techniques (June 10 - 11, 2009) NMC Specialty Hospital Al Nahda Dubai, UAE

• In Depth Physical Assessment of the Abdomen, Skin, Chest and Lungs, Eyes, Head, Ears, Nose, Mouth and Neck for Accurate Diagnosis & Treatment (January 7, 2007) CAP-Auditorium, Lipa City Batangas, Philippines

§ American pediatric Nurse Practitioner: In depth Physical Assessment techniques for Accurate Diagnosis and Treatment CAP-Auditorium (January 7, 2007) Lipa City, Batangas, Philippines

§ First Aid Training (Standard) Nursing Skills Laboratory (July 5-8, 2006) DMMC-HIS, Tanauan City, Batangas, Philippines

E D U C A T I O N A L B A C K G R O U N D

T R A I N I N G S & S E M I N A R

A C H I E V E M E N T S

§ Basic Life Support (CPR Training for Healthcare Provider Nursing Skills Laboratory (July 3-4, 2006) DMMC-HIS, Tanauan City, Batangas, Philippines

§ Intensive Training on Basic Advance Life Support Intensive Discussion on Emergency Obstetric Nursing

Comprehensive Cardiopulmonary Anatomy and Physiology (January 8, 2006) Lima City Hotel, Lima Technology Center Malvar, Batangas, Philippines

§ 2007 Census of Population (POPCEN) 4th Level Training (July 23 – 26, 2007) NSO Batangas City, Philippines

C H A R A C T E R R E F E R E N C E S

Sr. Norlina S. Dalumpines

Principal

Servite Catholic School

Poblacion 5, Laurel, Batangas

Contact # 091*-***-****

Aniana A. Timbre

First Vice President/Department Head

Loans Accounting & Monitoring Department

BDO Unibank, Inc.

BDO Corporate Center Makati Avenue, Makati City

Office Tel # 878-4121

Contact # 091*-***-****

Maria Celita B. De Leon

Prinicpal III/Area Chairman

Wenceslao Trinidad Memorial National High School

Area III Elias Caray St., Poblacion 1, Laurel, Batangas Contact # 099*-***-****

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