MA. GLAIZA PAJARES PEREZ
*-* ** ********* * de Pebrero St. Mandaluyong City
Motivated and quality-oriented data processor with extensive experience in insurance claims processing, Workers' Compensation bill review and revenue cycle management. Skilled in interpreting Explanation of Benefits (EOB's), resubmitting corrected claims and appeals, and maximizing reimbursement through A/R follow-up.
Strong background in Claim Entry & Payment Posting
Knowledgeable in Facility & Professional claim forms
Familiarity with Medical and Insurance terminologies; HIPAA Compliance
Background in ICD 9 and 10, CPT and HCPCS
Strong analytical skills and a broad range of computer expertise.
Ability to work both independently as well as collaboratively
Typing speed: 40-50 wpm with accuracy.
OFFICE STAFF. November 2019 to Present
Sunlife of Canada Phils. Inc. (Bamboo NBO)
Responsible for the recruitment process of financial advisors
Coordinate schedules of exams, trainings and contract signing
Assist Managers in coordinating with their client’s insurance policies
Perform other administrative duties
ASSISTANT. February 2017 to July 2019
Eng’r. George Perez, Sr. (G. P. PEREZ & ASSOCIATES)
Collects reimbursements from clients and conducts bank deposits
Research lot plan and lot description at Land Registration Authority & DENR (NCR)
Perform other administrative duties
BILL REVIEWER. May 2016 to January 2017
Shearwater Health (former HCCA Health Connections)
Keys pre-coded billing data into the system
Identifies and forwards complex bills to claims examiners
Codes provider bills in accordance with claims management system notes and state guidelines.
Follows workers compensation guidelines to evaluate the services
Compares qualifications of service provider with service provided
TRAVEL CLAIMS PROCESSOR. February 2015 to January 2016
RR Donnelley Philippines Inc.
Conducts travel claims processing activities which includes consolidating documents, analyzing claims,
processing claims payments and sending correspondences
Conducts call outs for claims related information
REVENUE CYCLE MANAGEMENT SPECIALIST. July 2014 to February 2015
E4E Global Services Philippines, Inc.
Responsible for end to end collections including patient demographics, charge entry and eligibility verification, payment posting, transmission and rejections, denials and correspondence files and accounts receivables follow-up
PAYMENT POSTING ASSOCIATE. October 2012 to February 2014
Microsourcing Philippines, Inc.
Performs all aspects of receiving, sorting, batching & line item posting of charges and payments
Review existing patient accounts and updating any applicable information
Communicates with Client, as appropriate, to clarify discrepancies in patient demographics, insurance information and charge posts
Responsible for the accurate and timely entry of data into the program’s website and assuring the transmission of completed data
Verifies entered payment and account data by reviewing, correcting, deleting and reentering data; purging files to eliminate duplication of data
Monitors and updates logs for deposits, balances and batch tracking
MEDICAL TRANSCRIPTIONIST. June 2011 to June 2012
EData Services Philippines, Inc.
Interpret and transcribed various types of medical reports from dictations, chart notes, histories, patient records etc. by physicians and other providers in order to document patient care
Best Quality for the month of September and October 2016, Shearwater Health
Commendations for the month of September and October 2015, RR Donnelley Phils., Inc.
Outstanding team performance for the last quarter of the year, December 2014 - E4E Global Services
Outstanding performance and Exceptional commitment Award, February 2014 – Microsourcing Phils., Inc.
RIZAL TECHNOLOGICAL UNIVERSITY
BS Biology major in Biotechnology
Year 2006 to 2010
Branch Manager, Sunlife Bamboo NBO
Secretary, Sunlife Bamboo NBO
Eng’r. George P. Perez
G. P. PEREZ & ASSOCIATES
Team Lead, Shearwater Health
Madonna De Venecia
Supervisor, RR Donnelley Phils., Inc.
Supervisor, E4E Global Services, Inc.
Production Supervisor, MicrosourcingPhils. Inc. 091********
Production Supervisor, eData Services Phils., Inc.