Sofia Mei Zapanta

SOFIA MEI ZAPANTA VIRTUAL MEDICAL ASSISTANT PROFILE Financial management played a role to contribute and establish the significant skills and experience in the Medical AR Team. Acquired knowledge and practiced teamwork in meticulous Medical and Clinical reimbursement process. Managed in providing customer service to clients. Aimed to continue providing services while expanding expertise in the healthcare staffing industry. EDUCATION Bachelor in Science in Business Administration - Major in Financial Management - Far Eastern University (FEU) Manila Accounts and Business- Management (ABM) Strand Diliman College 2022 - 2023 3 years of Medical AR work Medicare Knowledge And EMR Tools Used Epic System Sofware NTT Data Philippines Inc. Claim Specialist Ability to handle sensitive information effectively Utilized EHR Systems WORK EXPERIENCE Customer Senior Representative SKILLS AND QUALIFICATIONS 2023 - 2025 Optum Healthcare Solutions Optimizing claim submissions and scrubbing claims, errors, rejections, and resolving denial issues. Monitoring A/R to identify trends with specific patients or payers, knowledgeable of contracts, regulatory or contractual billings criteria to establish an account's ability to be paid after initial payer denial. Handled duplicate billings, benefit coordination, medical records, or clinical papers as needed to accelerate insurance claim payment. Managed and collect receivables by contacting clients by phone, email, and letter and negotiate within specified guidelines with the payers. Analyzing the services are appropriately billed to patients and insurance companies, while ensuring that payments are collected, accurately documented, and processed in a timely manner. Taking several steps to increase cash flow, such as following up with insurance companies, reviewing the insurance portal, and validating patient eligibility. Keeping detailed records, including bills from provider, notices from health plan, copies of denial letters, appeal requests and medical information related to the case. Submitting reconsideration requests, technical appeals, ans required medical records via portal, fax and mailing channels. Have experience in Collections (both major insurance and self pay) Analytical Skills Multitasking Skills Time Management Outstanding customer service and phone skills Attention to Detail Handled Medicaid Accounts Receivables Handled Commercial Major Payors Knowledgeable with HIPAA Privacy Rule