April Ann Llanes

APRIL ANN LLANES ㅡ Skills #386 Purok 5 Antipolo del Sur Lipa City, Batangas 4217 - / -- A certified Customer Care Professional who knows the duties and responsibilities with HIPAA Certification Over 6 years of experience in working as a healthcare professional who specializes in processing claims and checking patient’s benefits Computer literate Can easily understand new task-quick learner Can easily adapt to new work environment Ability to multitask Strong motivational and logical skills Ability to work under pressure Interpersonal Skills Customer service skills Can perform analytical thinking ㅡ ExperiencesTeletech Lipa DC August 2014 - February 2015, Lipa City Batangas 4217 Producer Help Desk Assisting new brokers to create account and providing necessary information on how to get leads Helping brokers navigate website, purchase available supplies and also assisting brokers to reset their passwords on their account Responsible for searching appropriate facility/doctor for patient’s visit Checking available plans for specific states where patients are residing and giving them estimated rates on the services applicable to their current status Assisted brokers in selecting most appropriate plans for Medicare Supplements and Prescription Drug plans Teletech Lipa DC March 2015 - March 2017, Lipa City, Batangas 4217 Customer Care Representative Optum Health Behavioral Solutions Worked with healthcare professionals and providers in discussing, reviewing and checking their submitted claims. Providing them necessary information if their submitted claims was processed correctly and giving them explanation if it is denied. Also giving them options on what they can do if the claim was denied like submitting an appeal. Responsible in reviewing and discussing Mental Health, Substance Abuse and Autism benefits Assisting in providing Employee Assistance Program benefits of a member as well as processing claims for the said program. Checking primary and secondary coverages of a member as well as government mandated insurances and patient’s responsibility Using the following systems : LINX , ISET, IBAAG , PAAS, Live Facets and CDB Optum Health Global Solutions April 2017 - 0ctober 2018, Mckinley Hills Fort Bonifacio, Taguig City Customer Care Professional Worked with healthcare professionals and providers in discussing, reviewing and checking their submitted claims. Providing them necessary information if their submitted claims was processed correctly and giving them explanation if it is denied. Also giving them options on what they can do if the claim was denied like submitting an appeal. Responsible in reviewing and discussing Mental Health , Substance Abuse and Autism benefits Using the following systems : LINX , ISET, IBAAG , PAAS, Live Facets and CDB Checking primary and secondary coverages of a member as well as government mandated insurances and patient’s responsibility Assisting in providing Employee Assistance Program benefits of a member as well as creating authorizations and processing claims for the said program. Creating authorization for necessary services needed by patients based on their selected plans Optum Health Global Solutions October 2018 - December 2019, Mckinley Hills Fort Bonifacio, Taguig City Invent o ry Manag e m e nt Repre s e nt at iv e (Inve nt o ry Manag e m e nt, DCSM) Analyzing emails about insurance applications submitted by brokers Assigning emails to different department teams based on the insurance application Checking if the application is for medical, dental or vision Identifying types of plans, plan codes and group name Phoenix Virtual Solutions May 2021- Jan 2022; 40th Floor PBcom Tower, 6795 Ayala Avenue, Corner V.A. Rufino St, Makati, 1226 Patient Support Specialist (Fulgent Genetics) Answering inbound calls about Covid-19 and genetic tests inquiries Doing outbound calls to patients to verify the correct information about their insurance to reprocess the claim Closing tickets under Jitbit and HelpScout regarding insurance and patient’s inquiries Approving and rejecting billing statements of Covid-19 and genetic tests Sends out collection notices through email for genetic tests Has knowledge in utilizing Matrix, 3cx (phone dialer), FLIMS, XIFIN, Frontrunner, UHC portal and Availity Has knowledge in creating SOP manuals and excel files for different processes concerning the business Knowledgeable in using Google Meet to set up meetings ㅡ EducationJose K. Obando Memorial School June 1998- March 2004, Lipa, Batangas Graduated with honors The Mabini Academy June 2004- March 2008, Lipa, Batangas Consistent cream of the crop student amongst the batch Belonged to the top decile of the class Voted as the secretary for the Filipino Guild’s club Received 100 percent scholarship grant from third to fourth year AMA Computer College June 2008-March 2010, Lipa, Batangas Bachelor of Science in Information Technology ㅡ Achievements➢ Promoted as part of the Quality Team for two months Consistent awardee for the Top Agent that meets the metrics for three consecutive months during the course of tenureship Recognized as UES Superstar Character References available upon request.