John Patrick B. Zaragoza

JOHN PATRICK ZARAGOZA INSURANCE VERIFICATION & BILLING SPECIALIST WORK EXPERIENCE Insurance Verification and Dental Billing Specialist PERSONAL PROFILE With over 10 years of working in a BPO corporate and freelance setting, I was able to acquire knowledge in doing back support role specializing in healthcare industry setup. And in this industry it sharpened my communication skills, problem-solving and decision making abilities as well as instilling me a deep sense of adaptability. This gives me the edge in giving consistent positive results through utmost efforts and maintaining a strong commitment to excellence. EDUCATIONAL BACKGROUND Hanyoung Theological University 2016 Masters in Psychology and Counseling TRAINING AND CERTIFICATIONS HIPPA Awareness for Healthcare Providers ( August 29, 2022 ) Leadership Training Seminar for Medical Billers II ( 2017 ) Leadership Training for Christian Youth Camp ( 2010 ) LANGUAGE English Filipino MedVA PH June 2020 - Present Clients: Atlas Dental Care Los Angeles Center for Maxillofacial Surgery (LACOMS) Beverly Hills Oral Surgery Center Checking patient's benefits whether they are still eligible and if the services for a specific practice are covered through the use of insurance portals or by simply calling their customer service line. Knowledgeable what are the differences between Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), Health Management Organization (HMO), Medicare, Medicaid, and Worker's Comp plans. Proficient in using Dentrix, and DSN softwares and has basic knowledge about Eaglesoft. Obtaining fee schedules and information about the provider's network participation. Billing procedures done and sending pre-estimate requests using DentalXchange. Knowledgeable how to use PDF application for any documents. Collections and Billing specialist Freelance - United States of America (USA) - 40 hours a week November 2018 - November 2020 Clients: Journey to Wellness Inc. (WFH) NeuroCognitive Institute (WFH) Fulton Medical Center (WFH) I was responsible for charge and payment entry within Electronic Health Records. Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account/ claim adjudication; Responsible for correcting, completing, and processing claims for all payer codes. Analyzing and interpreting that claims are accurately sent to insurance companies. Doing AR follow-ups with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports Sending appeals when a certain claim is denied unnecessarily. I am also assisting in reconciling deposit and patient collections, especially for those who do not have the means to pay the balance in full. Knowledgeable in reading EOBs and on how to post them. Attending meetings alongside providers when sudden changes will be implemented. JOHN PATRICK ZARAGOZA INSURANCE VERIFICATION & BILLING SPECIALIST WORK EXPERIENCE Customer Care Associate SKILLS & ABILITIES Proficient in Microsoft Office Suite, Google Docs, Internet navigation, and email applications. Familiar with various communication tools such as Slack, Zoom, Skype, Nextiva, Ring central and 3CX Experienced in navigating and utilizing Dentrix, DSN, Kareo, AdvancedMD, Practice Fusion, and basic knowledge about Eaglesoft. Detail-oriented, versatile, and selfmotivated individual Maintains a confident and professional demeanor at all times. Possesses a strong and confident communication skills Tech-savy with a strong sense for learning, adapting and multi-tasking Respectful towards colleagues and leaders NTT DATA PH August 2018 - November 2018 Client: Tenet Health (California Account) I am calling various insurance companies to check whether the claim has been processed. Investigating all claims that have not been closed out or adjusted. Documenting all information gathered from insurance representatives daily. Requesting support from other departments about obtaining and attaching medical records and all other necessary information for the claim to get processed. Attending weekly team huddles and meetings for any announcements and adjustments regarding work. Medical Biller I and II SourceFit PH August 2016 - August 2018 Client: Automatic Claims Processing Inc. ( ACP ) Entering patient demographics in Kareo and ensuring that all information is accurate to avoid claim rejections and denials. Entering charges by the use of CPT codes and modifiers, place of service, and amount within Kareo and Practice Fusion for Clinical, Physical Therapy, and Laboratory specialties. Doing AR follow-ups with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports. Posting EOBs and fixing denied procedure codes at the same time. Re-sending corrected claims when they are rejected by the clearinghouse. Having open communication with Providers and their staff regarding claim concerns or changes in billing. Attending weekly huddles and meetings within the team for any sudden changes and announcements. Factory Worker (South Korea) Jubilee Food and Beverage Co. (Dessert Department) October 2014 - November 2015 Taekwang Precision Co. (Hand-Brake Department) January 2014 - September 2014