Edwin Reyes

EDWIN REYES,RPM MEDICAL ADMIN | SCHEDULER | BILLER Pasig City, Metro Manila-| - SUMMARY I am a detail-oriented Medical Administrative Specialist with expertise in medical billing, insurance verification, prior authorization, and patient case management. Skilled in handling high-volume patient interactions, resolving escalations, and maintaining accurate medical documentation with precision and efficiency. Proficient in EHR/EMR systems (SimplePractice, Availity, PHICURE, SugarCRM), leveraging technology to streamline healthcare operations while ensuring strict HIPAA compliance. Adept at thriving in fast-paced environments, applying strong problem-solving, communication, and organizational skills to enhance patient experience and revenue cycle efficiency. Dedicated to delivering exceptional administrative support, facilitating seamless collaboration between patients, healthcare providers, and insurance carriers to improve workflow and optimize patient care. SKILLS Patient Care and Management EHR/EMR Expert (Simple Practice, Availity, PHICURE, and SugarCRM) Medical Billing, Insurance Verification, Prior Authorization, and Scheduling Strong Work Ethic Organized and Creative Excellent Communication Strong Attention to Details Empathy and Compassion EHR/EMR: Simple Practice, Availity, PHICURE, and SugarCRM Microsoft Word, Excel, Google Suits, Microsoft teams, Zoom Ring central, WhatsApp, Skype, Discord, Sharepoint TOOLS Microsip, MatterMost, and Thunderbird WORK EXPERIENCE Medical Virtual Assistant | Assist Health Group Oct 2024 - Mar 2025 Scheduled and coordinated patient appointments via phone and email, ensuring accurate documentation of medical history, symptoms, and required referrals. Managed EHR/EMR systems, maintaining patient records, updating medical histories, and ensuring proper documentation for insurance claims and authorizations. Facilitated communication between patients, healthcare providers, and medical facilities, ensuring seamless coordination for referrals, and imaging requests (MRI, CT scans, X-rays) Ensured compliance with HIPAA regulations, maintaining strict confidentiality in handling sensitive patient information. Customer Service Representative - Escalation Specialist| Sagility Sep 2022 - Oct 2024 Managed complex escalations and disputes related to insurance verification, medical billing discrepancies, and claim denials, ensuring timely resolution for patients and healthcare providers. Provided expert guidance on insurance policies, coverage eligibility, and billing statements, improving patient understanding and satisfaction. Investigated claim disputes, collaborated with insurance companies, and advocated for patients to facilitate successful claims processing and reimbursement. Maintained accurate case documentation for each patient interaction, ensuring compliance with regulatory requirements and company protocols. Handled high-call volumes while maintaining professionalism, empathy, and efficiency in resolving patient concerns. Coordinated with internal teams and external insurance carriers to expedite claim approvals, corrections, and appeals, reducing processing times and minimizing claim denials. Additional Information Equipped with a dedicated home office setup, PC, and noise-canceling headset. Available during US business hours. Strong ability to work independently while collaborating with remote teams. CERTIFICATIONS HIPAA Certified Medical Virtual Assistant Training (PRO VA, MEDVA PH) Registered Psychometrician EDUCATION Bachelor of Science in Psychology Our Lady of Fatima University -)