Ma Ginnesa Romero

 MA. GINNESA N. ROMERO #287 B Sampaguita St. Cembo Taguig City- - SUMMARY: Looking for an opportunity in the Medical Field that will help me utilize my good communication skills, strong moral character and knowledge in medical claims and other health insurance concerns. SKILLS: Good customer service skills HIPAA Compliance Medical terminologies (CPT codes, ICD-10, HCPCD, Diagnostic codes, Revenue codes) Active listening skills Capability to multi task Dependable and self-motivated WORKING EXPERIENCES: PHOENIX VIRTUAL SOLUTIONS (April 16, 2021 -August 31, 2024) Fulgent Therapeutics ( Error Processing Specialist) -positioned in AR department, checking and analyzing both denied and paid claims using portals for rebilling claims properly, submitting appeals for incorrectly processed claims. -positioned in Refunds and Credit Balance Department, correcting amounts that are over and under paid based on the services rendered for each claim. -positioned in Error Processing Department, checking all patient information including insurance information in both system and portal to rebill claim directly. RESULTS - CX (May 07, 2019 - March 31, 2021) Highmark Provider Services (Customer Service Representative) - Handled Patient’s eligibility, authorization checking and claims (approval, rejections and denials). Receiving calls from Medical Providers to provide further informations of patient's eligibility and insurances. - Also trained with MEDCO (Express Scripts) which includes checking patient's eligibility for prescription, coverage, authorization and claims. ALORICA TELESERVICES (October 25, 2015 - May 1, 2019) Anthem Blue Cross Blue Shield (Customer Service Representative) October 25, 2015 - November 17, 2017 -Handled patients eligibility, authorization checking using codes, claims (approval, rejections and denials). Receiving calls from Medical Providers to provide further informations of patient's eligibility and insurances. Express Scripts (Patient Care Advocate) November 20, 2017 - May 1, 2020 -Handled member concern with eligibility, coverage or benefits, medication authorization and claim status (approval, rejection and denials). Receiving calls from Patients regarding their eligibility, prescription refills and tracking of their orders. -Also trained in the Billing department where I process payment for our member’s monthly premium. 7-11 Corporation October 07, 2014 - March 15,2015 Cashier/clerk New Zealand Creamery May 16, 2013 - October 16, 2013 Production Stuff Unimec Supermart June 2, 2012 - November 7,2012 Cashier Jollibee Foods Corporation April 1, 2010 - September 3, 2010 Counter Crew PERSONAL PROFILE: AGE: 33 years old DATE OF BIRTH: November 12, 1990 PLACE OF BIRTH: Cavite RELIGION: Catholic EDUCATIONAL BACKGROUND: TERTIARY: Montessori Professional College : Diploma in Science of Practical Nursing : 2008 - 2010 SECONDARY: Saint Gregory Academy : 2003 - 2007 PRIMARY: Holy Angel Montessori School : 1999 - 2003 CHARACTER REFERENCES: Ms. Sarah Kay Castillo Alorica Teleservices- Ms. Jesiebel Leis Result Cx- Ms. Nerika Lerize Muana Phoenix Virtual Solutions- I hereby certify that the facts written above are true and correct. ______________________________________ Ma. Ginnesa N. Romero