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Data Processor

Location:
Mandaluyong, Philippines
Salary:
23000
Posted:
March 23, 2020

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Resume:

MA. GLAIZA PAJARES PEREZ

*-* ** ********* * de Pebrero St. Mandaluyong City

adce03@r.postjobfree.com /adce03@r.postjobfree.com

090********

PROFESSIONAL SUMMARY

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.

SKILLS:

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.

PROFESSIONAL EXPERIENCE:

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

ACHIEVEMENTS:

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.

EDUCATION:

RIZAL TECHNOLOGICAL UNIVERSITY

BS Biology major in Biotechnology

Year 2006 to 2010

REFERENCES:

Marilou Arquero

Branch Manager, Sunlife Bamboo NBO

091********

Racquel Viray

Secretary, Sunlife Bamboo NBO

091********

Eng’r. George P. Perez

G. P. PEREZ & ASSOCIATES

097********

Jonalyn Orais

Team Lead, Shearwater Health

090********

Madonna De Venecia

Supervisor, RR Donnelley Phils., Inc.

092********

Kathrina Lim

Supervisor, E4E Global Services, Inc.

091********

Ericson Mercado

Production Supervisor, MicrosourcingPhils. Inc. 091********

Barbara Ranada

Production Supervisor, eData Services Phils., Inc.

090********



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