MARY ROSE DERECHO
Medical Virtual Assistant-E
-
Brgy.
Sambag
Jaro,
Iloilo
City Philippines 5000
ACHIEVEMENTS
NPS NINJA
December 2023
Highest survey counts and
promoters coming from
providers in whole Medicaid
LOB
MEDICAID TOP
PERFORMER AGENT
For passing the metrices in
quality,ATR and NPS
Local Youth
Development
Council
Leadership skills and
implementation of activities
for the youth
SUMMARY
I am an experienced HealthCare Associate with 1 year and 5 months of experience
in healthcare administration. Specifically, Medicare, Medicaid and Commercial
Plans. I utilize advanced technology to optimize workflows, manage patient
records, and improve efficiency. With a strong understanding of medical
terminology, procedures, member's eligibility,benefits,claims and authorization. I
prioritize privacy and confidentiality and stay updated with the latest advancements
in the field. As a dependable team player, I am ready to contribute to the delivery of
exceptional healthcare services.
EXPERIENCE
Health Care Associate
Humana/Sagility
•
•
•
•
ADVOCATE of
"Voice of
Cameleon's
Children"
Facilitated activities and
collaboration on youth
council
EDUCATION
Bachelor of Business
Administration major
in Business
Management
Central Phillipine
University
07/2018 - 07/2022
11/2022 - 04/2024
•
•
Provided exceptional customer service to clients in the healthcare industry,
including healthcare providers, other stakeholders and members if necessary.
Handled a high volume of inquiries, concerns, and requests, ensuring prompt
and accurate resolution.
Maintained a professional and empathetic demeanor while handling sensitive
and confidential information in compliance with privacy regulations.
Collaborated with cross-functional teams to streamline processes and improve
customer satisfaction.
Actively participated in ongoing training and professional development
programs to enhance skills.
Received positive feedback from providers for providing excellent service and
resolving issues efficiently.
EXPERT SKILLS
Insurance Verification (Eligibility and Benefits)
Claim Denials Resolution
Strong Microsoft Office skills
Prior Authorization/Referral Requirements and Status
Claim form filing
Collaboration
Research and attention to detail
Knowledge of CPT and ICD-10 coding
EMR Navigation (Athena,Octagos,Availity,ECW,Intergy and
Tebra)
RELATED TRAININGS
MediVirtuo Assists
02/2024 - 04/2024
Medical Billing and Credentialing Training
Medical Receptionist Training(HIPAA and Telemedecine, Call
Scenario between Patient and Receptionist)
Insurance Verification (Types of Insurance, Importance of
Insurance in U.S)
Prior Authorization Training
Understanding Medical Billing (Billing Cycle, Example of Out
of Pocket Costs, Types of Providers, Payers, Medical Codes,
and Types of Claim Forms)
Claim Rejection and Denial Management
Charge Entry/ Claims Submission
EMR Navigation ( Athena, Octagos, Availity, ECW, Intergy and
Tebra)
