ROI IAN C. COLLAO
CONTACT
Phone: -
Email:-Address: Pulong Buhangin, Santa Maria Bulacan 3022
LinkedIn: www.linkedin.com/in/roi-ian-collao-
PROFESSIONAL SUMMARY
I am a skilled healthcare claims specialist with nearly 10 years of experience in managing Medical, Hospital, and High-Dollar
claims, along with expertise in correspondence processing and appeals. I am proficient in Facets Software and excel in
verifying member benefits, processing authorizations, resolving claim disputes, and ensuring payment accuracy. With strong
analytical, communication, and problem-solving skills, I am adaptable and detail-oriented, committed to delivering excellent
service. I am eager to bring my experience and dedication to your company, contributing to streamlined processes and
overall success.
WORK EXPERIENCE
Appeals Specialist | April 2019 - January 2025
Accenture, Inc. | Mandaluyong City, Metro Manila
Reviewed and analyzed denied claims to determine the appropriate course of action for appeal.
Prepared and submitted appeal letters and supporting documentation to insurance companies.
Communicated with insurance carriers to follow up on the status of appeals and gather necessary information.
Correspondence Specialist | March 2018 - April 2019
Accenture, Inc. | Mandaluyong City, Metro Manila
Received, reviewed, and processed incoming correspondence related to claims, member accounts, and provider
inquiries.
Responded to written and electronic communications in a clear, accurate, and professional manner.
Researched and resolved issues raised through correspondence, collaborating with internal departments when
necessary.
High Dollar/ High Cost Claims Processor | May 2017 - March 2018
Accenture, Inc. | Mandaluyong City, Metro Manila
Documented all claim actions accurately within the claims processing system (e.g., Facets).
Reviewed and processed high-dollar or high-cost medical, hospital, and specialty claims in accordance with policy
guidelines and payer rules.
Analyzed supporting documentation, medical records, and coding to ensure claim accuracy and legitimacy.
Medical and Hospital Claims Processor | May 2015 - May 2017
Accenture, Inc. | Mandaluyong City, Metro Manila
Interpreted explanation of benefits (EOBs), CPT, ICD, and HCPCS codes to verify claim accuracy.
Evaluated claims for completeness, eligibility, and accuracy prior to approval or denial.
Identified and flagged discrepancies, duplicate charges, or documentation issues.
EDUCATION
SKILLS
Polytechnic University of the Philippines
HIPAA Compliance
Bachelor of Science (B.S.) in Entrepreneurship
Effective Communication
Santa Maria, Bulacan
Continuous Learning Mindset
Professionalism and Ethics
SECONDAY EDUCATION
Sacred Heart Academy of Sta. Maria (Bulacan), Inc.
Santa Maria, Bulacan
Strong Analytical Skills
Data Entry Proficiency
Medical Terminology
Appeals Process Proficiency
Multitasking
PRIMARY EDUCATION
Problem-Solving Abilities
San Francisco Elementary School
Organizational Skills
Frisco, Quezon City
Adaptability and Flexibility
Claims Investigation
Claims Processing
Computer Proficiency
Skilled in Facets System
