Abigail Tulauan

ABIGAIL B. TULAUAN E-mail address:-Contact Number: - ABOUT ME I have experience in healthcare industry, specializing in claims processing, eligibility verification, payments, denials, appeals, and medical records management. I consistently perform with accuracy and efficiency to support clients and ensure timely and appropriate resolutions. EXPERIENCE TOOLS EHR/EMR (Cerner & Practice Fusion) Canva Google Suite Microsoft Office Ring Central Zoom WhatsApp Webex Appeals Specialist Connext International Inc. July 2023 - June 2025 Reviewing EOBs and check claim status after determination Checking claim if processed and paid accordingly Resolving claim denials Re-submitting claims if confirmed that no claim on file Generating and submitting appeals and other documents to the insurances Follow-up appeals and takes appropriate action based on MVA SKILLS Familiar with EHR/EMR systems Insurance Verification Medical Billing the determination AR Collections Representative Optum Global Solutions October 2021 - July 2023 Reading and interpreting based on insurance explanation of benefits. SOFT SKILLS Time Management Ability to multitask Active Listening Flexibility and Adaptability Detail-oriented Organized and efficient Research and resolve payment discrepancies and resolving denials Prepare write off requests as needed for any uncollectable balances Documenting accurate notes on corresponding systems as needed Navigate and works payer websites. Initiate appeals to payers following the guidelines CERTIFICATIONS HIPAA Certified EDUCATION Polytechnic University of the Philippines - Maragondon Branch Bachelor of Science in Business Administration- outlined for that payer. Note account and track appeal to resolution. Customer Care Representative Conduent, Philippines June 2019 - October 2021 Answering inbound calls Assisting providers regarding patient’s eligibility verification, benefit coverage, providing claims and appeal status. Resolving claim denials and provide accurate and appropriate action to the providers.