Mark Neil Diaz

MARK NEIL S. DIAZ U3D T4 WOODSVILLE VIVERDE MANSION, WEST SERVICE ROAD, PARAÑAQUE CITY Mobile Number: - Email Address:- VALUE Dependable healthcare administration associate and medical biller with 5 years of experience with patient records, medical billing, prior authorization and healthcare policies. Committed to strengthening patients. Eager to provide navigant and its patients with the best solutions for sustained improvements in performance and profitability. Duties and Responsibilities: • • Determines requirements by working with patients. Answers inquiries by clarifying desired information; researching, locating, and providing information. Resolves problems by clarifying issues, researching and exploring answers and alternative solutions, implementing solutions, escalating unresolved problems. Fulfills requests by clarifying desired information, completing transactions, forwarding requests. Maintains call center database by entering information in accordance with HIPAA. Keeps equipment operational by following established procedures, reporting malfunctions Updates job knowledge by participating in educational opportunities. Enhances organization reputation by accepting ownership for accomplishing new and different requests, exploring opportunities to add value to job accomplishments. • • • • • • Work Related Experience: Red Cross Volunteer, Emergency Medical Team Teleperformance (Team Leader) Classic Sleep Care (Team Leader) Cognizant (Medtronic) Valor Global Philippines (Team Manager) ● November 2003 Sept2009–Nov 2014 Aug2015 –May 2017 July 2017 – Feb 2019 Mar 2019 - Dec 2021 BIO REFERENCE LABORATORY - GENPATH Team Manager Medical Billing Department- March 2019 – Dec 2021 Oversaw daily Billing Department functions, charge entry, payment posting, and reimbursement management. Collaborated with medical providers and office management to determine billing and documentation policies and ensure compliance. Reviewed and validated accuracy of charges including dates of service, services provided, location and provider signature. Completed and submitted CMS-1500 Forms. Connected with Insurance and patient aging to resubmit insurance claims when necessary. Coordinated with the team members and give daily updates with regards to the business. Researched insurance policies/eligibility and educated medical staff. Key achievements: • Medical billing team posted and submitted claims within 24 hours of receipt. • Supervised a 15-member team and assisted with training new hires. • Was given Living Our Values (LOV) Award for managing the whole operation and still hit monthly and quarterly performance goals. ● MEDTRONIC – Pacemaker Patient Service Representative II – July 2017 – Feb 2019 Maintained confidentiality of patient health information in compliance with HIPAA regulations. Calls MDO to verify the contact information necessary for the patient's card. Trace the whereabouts of the doctor if they no longer practice in that state or facility. Do insurance verification to Medicare, Medicaid and commercial insurances. ● CLASSIC SLEEPCARE Prior Authorization Specialist – August 2015 – May 2017 Collaborate with other departments to assist in obtaining pre-authorizations in a cross-functional manner. Receive requests for pre-authorizations and ensure that they are properly and closely monitored Review the accuracy and completeness of the information requested and ensure that all supporting documents are present Receive requests for pre-authorizations and ensure that they are properly and closely monitored Manage correspondence with insurance companies, physicians, specialists, and patients as required Look through denials and submit appeals in a bid to get them approved by insurance companies Create patients’ records and accounts and ensure that pre-authorization information is properly updated in them. ● Teleperformance Customer Service Representative Team Leader - Sep 2009 – Nov 2014 Hiring, training, and preparing call center representatives to respond to customer questions and complaints and troubleshoot problems with services or products. Monitoring and evaluating agent performance, providing learning or coaching opportunities, and taking corrective action, if necessary. Preparing reports and analyzing data to assist management as they determine call center goals. Working with other supervisors and management team members to support agents and maximize customer satisfaction. Anticipate escalation and take over calls when needed. Prepare monthly/annual results and performance reports. Key Skills • • • • • • • • • Hospitality Leadership Teamwork Productivity Adaptability Rapport building Communication Organizational skills Collaboration Educational Background: College: Western Mindanao State University Bachelor of Science in Nursing Normal Road, Baliwasan Zamboanga City April 2009 High School: Zamboanga City State Polytechnic College R.T. Lim Blvd.,Baliwasan, Zamboanga City March 2005 Elementary: University of Mindanao Matina, Davao City March 1998 Qualifications and Skills: ● ● ● ● ● ● ● ● ● ● Willing to work at any shifts Good in oral and written communication especially in English and Tagalog. Can work in minimal supervision Supervisory skills Knowledge of modern office equipment and procedures Attentiveness to detail Ability to type and operate word processing programs Ability to prioritize duties, delegate responsibilities, and evaluate the work of others Ability to maintain confidentiality and professionalism Ability to work efficiently and cooperatively References: 1. Ms. Maebel Lacastesantos Classic Sleepcare- Operation Manager Contact No. 0936 -. Cedric Pasion Cognizant - Talent Manager--3. Mr. Ron Fernando Site Director – Valorglobal Philippines 0917 – 525 – 1911/-- I hereby certify that the facts contained in this resume are true and correct to the best of my knowledge. _____________________ Mark Neil S. Diaz Applicant