David Dwight Guloy

David Dwight Guloy 📧-| 📱 - 📍 Laguna, Philippines | 🔗 LinkedIn Professional Summary Experienced Healthcare Virtual Assistant with 9+ years of U.S. healthcare support experience in dental, medical, and insurance sectors. Skilled in remote patient communication, insurance verification, claims processing, EHR/EMR management, and appointment coordination. Adept at handling sensitive data with strict HIPAA compliance and supporting healthcare teams in fast-paced virtual environments. Proficient in tools like Availity, Exchange, and various EMR platforms. Core Competencies Insurance Verification Claims & Authorization Processing Appointment Scheduling HIPAA Compliance Medical Correspondence Dental & Medical Admin Support EHR/EMR Documentation Revenue Cycle Management (RCM) and Portal Navigation Remote Communication & Multitasking Professional Experience Dental Virtual Assistant Western Oral Facial Surgery & Dental Implant Center – California, USA March 2022 – April 2025 (Remote) Verified insurance benefits and pre-authorizations for dental procedures through online portals and phone calls. Created and sent referral letters for extractions, implants, and follow-up care. Managed claim submissions daily, ensuring on-time processing and revenue flow. Handled patient registration updates and automated SMS appointment reminders. Clinical Intake & Correspondence Specialist Blue Cross Blue Shield (via Cognizant) September 2022 – September 2024 (Remote Support) Processed authorization requests for mental health services, reviewing eligibility and medical necessity. Communicated with providers via portals and correspondence letters to finalize approvals. Verified coverage through Exchange and Availity; ensured all documentation met payer requirements. Reviewed EMR documentation to support claims and authorizations. Managed Care Specialist Dexcom (via Cognizant) March 2019 – August 2022 (Remote/Hybrid) Reviewed orders and compliance documents (CMNs, AOBs) for CGM device coverage. Initiated and tracked insurance authorizations via fax and online systems. Maintained HIPAA standards in handling patient records and communications. Coordinated with insurance companies for benefits and claim resolutions. Customer Service Advocate Cigna Global Health (via Hinduja Global Solutions) March 2015 – February 2019 (Call Center – Global Support) Responded to global provider and member inquiries regarding healthcare benefits and claims. Resolved payment disputes, processed reissuance requests, and verified insurance coverage. Delivered high-quality service while managing large call volumes in a healthcare setting.