Shierlyn Abid Ariola

SHIERLYN ABID ARIOLA --PROFESSIONAL SUMMARY: • Results-driven professional with over 9 years of combined experience in sales, data management, collections, billing, quality auditing, and system configuration within the healthcare IT sector. • Proven track record of success in client-facing roles and outbound call handling, with over 3 years of experience in each. • Adept at analyzing complex data to resolve receivable balances and streamline operational processes. • Highly skilled in administrative support, customer service, and accurate data entry. • Proficient in industry-standard tools and software, including Salesforce, Hubstaff, JIRA, ClaimsXten, EPIC, Prestige Billing, E-Premis, and Facets. • Strong communicator with excellent interpersonal skills and a solid command of Microsoft Office applications (Word, Excel, Outlook, PowerPoint). • Committed to delivering high-quality results in fast-paced, detail-oriented environments. KEY SKILLS: Healthcare Operations & Revenue Cycle Management • Medical Claims Processing • Payment Posting • Collections & Accounts Receivable • Denial Management • Appeals & Medical Records Handling • Medical Billing • Authorization Review Client & Project Management • Client Relationship Management & Engagement • Requirements Gathering, Development & Implementation • Triage, Troubleshooting & Problem Solving Technical Skills • Data Analytics & Reporting • JIRA Navigation & Task Management • Payment Systems Maintenance, Updates & Testing PROFESSIONAL EXPERIENCE: Senior Payment Accuracy Advisor (Business Analyst) Lyric (formerly Change Healthcare Philippines Inc.) – Taguig City | June 2021 – December 2024 • Consulted with clients to gather, analyze, and document business intent and technical requirements for system implementations and updates. • Led triage, troubleshooting, and resolution of issues during implementation phases, Go Live, and postGo Live production support. • Provided ongoing guidance to clients regarding system content updates and their impacts on production and testing environments. • Reviewed and responded to client inquiries, ensuring timely and accurate information. • Analyzed client requests for updates to production (PROD) and user acceptance testing (UAT) environments, ensuring proper configuration and compliance. • Developed and configured records within client payment systems in accordance with requirements. • Performed unit testing of dictionaries and workflows to validate expected system functionality and accuracy of changes. • Executed test scenarios within client UI for QA purposes and troubleshooting support. • Created and maintained detailed documentation and support tickets in JIRA for tracking and audit purposes. • Documented all client interactions, including support provided and packages availed, to ensure consistent communication and knowledge transfer. • Maintained strong client relationships by providing proactive process, system, and inquiry updates during daily client calls. Medical Billing Specialist Conifer Global Business Center – Taguig City | January 2020 – June 2021 • Reviewed billing forms for accuracy and completeness prior to submission. • • • • • • Entered charges into the system, ensuring correct billing information and editing discrepancies when needed. Coordinated requests for medical coding, prior authorizations, and provider credentialing to support timely claim processing. Served as point of contact and team support in the supervisor’s absence, ensuring smooth workflow and issue resolution. Examined submitted documents to confirm completeness, accuracy, and reliability for billing and audit purposes. Verified system-entered information for accuracy and alignment with source documentation. Provided assistance with quality audit processes to help maintain compliance and billing integrity. Sr. Collections Representative (Subject Matter Expert) Optum Global Solutions – Quezon City | February 2017- January 2020 • Provided day-to-day support to the supervisor, ensuring operational continuity and effective team performance. • Conducted quality audits of team output to maintain compliance and uphold service standards. • Assumed full supervisory responsibilities during supervisor's leave, managing workflows and addressing escalations. • Communicated regularly with onshore partners, clients, and directors to provide updates and align on deliverables. • Reviewed and processed requests related to coding, billing, and account adjustments submitted by onshore teams. • Assisted team members with process-related questions to ensure adherence to guidelines and promote efficiency. • Prepared and reported on team outputs, performance metrics, and productivity to leadership and stakeholders. Collections Representative • Handled aged and escalated medical claims, ensuring timely resolution and reimbursement. • Reviewed Explanation of Benefits (EOBs) to identify payment discrepancies and analyze denial reasons. • Communicated directly with payers to follow up on outstanding claims and verify reasons for denial or underpayment. • Prepared and submitted appeals, medical records, and supporting documentation to facilitate claim reconsideration and payment. • Resolved claim account balances through diligent follow-up, accurate adjustments, and appropriate payment posting. • Posted payments and adjustments in the system, maintaining accuracy in patient and payer accounts. • Generated and maintained key team performance reports including Straight Utilization, Hourly Production, and Report Tracker. Data Analyst/Claims Processor Accenture Philippines – Mandaluyong City | May 2015-January 2017 • Reviewed and processed insurance claims in alignment with members’ health plans and benefit structures. • Handled member enrollment, approvals, and ensured accuracy and compliance with plan guidelines. • Managed appeals, grievances, and denial processes to ensure fair resolution and adherence to regulatory standards. • Investigated potential fraud and inconsistencies in submitted documentation and claims. • Maintained timely processing of transactions to meet service level agreements and internal deadlines. • Examined submitted documents for completeness, accuracy, and reliability prior to processing. • Accurately priced customer bills based on applicable coverage, services rendered, and plan policies. INTERNSHIP EXPERIENCE: Environmental Protection and Waste Management Program – Quezon City Hall November 2013-February 2014 EDUCATION: Bachelor of Science in Entrepreneurship Quezon City Polytechnic University | 2015