Dana Nadine Tongco

DANA NADINE TONGCO MEDICAL BILLER I INSURANCE VERIFICATION SPECIALIST I HEALTHCARE COORDINATOR I VIRTUAL ADMIN ASSSTANT PROFILE WORK EXPERIENCE I am dedicated to ongoing learning and professional growth, keeping abreast of the latest trends and regulations within the industry. My background as a Medical Biller has provided me with the expertise to expertly navigate complex billing systems and software, ensuring precise and efficient claims management. By nurturing collaborative relationships and showing empathy, I strive to improve patient satisfaction and contribute to the overall success of healthcare services. I am enthusiastic about using my skills to make a meaningful impact on any team and am actively pursuing new opportunities for advancement within the healthcare sector CORE COMPETENCIES HARD SKILLS CLAIMS SUBMISSION DENIAL MANAGEMENT & APPEALS PAYMENT POSTING & RECONCILIATION REVENUE CYCLE MANAGEMENT (RCM) ACCOUNTS RECEIVABLE (A/R) FOLLOW UP HIPAA & HITECH COMPLIANCE PAYER-BILLING SPECIFIC BILLING GUIDELINES SOFT SKILLS CLEAR COMMUNICATION STRONG PROBLEMSOLVING CAREFUL WITH DETAILS MANAGES TIME WELL FLEXIBLE IN CHANGING SITUATIONS WORKS WELL WITH OTHERS SUPPORTIVE WITH CLIENT AND PATIENT NEEDS TECHNICAL EXPERTISE Billing Software: Hellonote, Eclinicalworks,Tebra, NextGen Healthcare Microsoft Office Suite: Excel (Advanced), Word, Outlook Clearing Houses: Novalon, Availity, Change Healthcare End-to-End Medical Billing Specialist Premier Medical Billing Remote | August 2022- October 2025 Ensuring patients insurance status is confirmed and the specifics of their coverage are clarified. Collecting vital patient information, including names, addresses, dates of birth, insurance details, and medical histories. Carefully doing charge entry ensuring that all relevant information is included in the claim and is prepared for submission. Summarizing patient payments, insurance checks received via Electronic Remittance Advice (ERA), and Explanation of Benefits (EOB). Actively tracking and resolving claims and outstanding balances with both insurance companies and patients. Carefully doing investigation, analysis, and resolution of denied claims. Encompasses receiving referrals and creating patient charts. Doing inbound and outbound calls to communicate with both patient and insurance providers Patient Care Coordinator Lynn Health Remote | January 2021- July 2022 Registered and onboarded new members to Lyn Health. Delivered exceptional virtual patient experience and helped patients prepare for their provider visit. Communicated with patients including obtaining medical history, verifying pharmacy information, patient education and obtaining screenings. Assisted members with care coordinator such as referrals (including urgent care needs, behavioral health, and community resources), appointment setting and following up on recent visits and lab/services. Participated in care plan review in Lyn Health multidisciplinary care team including a Nurse care Manager and Physicians. Work with clinical reviewers to develop letters and request medical records. Document attempts to obtain requested information in system and keep clinical reviewers informed of status. Check emails and faxes for receipt of information. Follow up on assignments and ensure that cases move through the process within allotted timeframes.