Wilson Rigos

WILSON MARTIJA RIGOS 68 Sta.Cruz, Pangao Lipa City Batangas, Philippines-Skype: rigoswilson (- EMPLOYMENT HISTORY: REVENUE CYCLE MANAGEMENT (RCM) SUPPORT Freelancer August 2017 - Present • • • • • • • • • • • • • Responsible for overseeing billing accounts and helping departments resolve their revenue cycle problems. Oversee the billing teams that manage accounts, communications with insurance, collections, contract analysis, cash posting, billing transactions with clients Review unpaid accounts to determine status and appropriate action required from HealthFusion Contact insurance payers utilizing insurance web portals and phone calls to retrieve claim status Review, research, and rectify all denials and correspondence from insurance payers Adhere to HIPAA policy and procedures Send corrected claims, reconsiderations, and appeals to insurances as needed Notify Account Manager of recurring issues or errors Apply basic billing and coding knowledge to rectify a claim denials Follow-up on outstanding claims every 30 days Research appeal status if no correspondence have been received within 30 days Clear rejections list daily by correcting basic errors and identified issues per rejection reason Perform other duties and projects assigned ADMINISTRATIVE ASSISTANT January 5, 2015 – July 25, 2017 Al-Jubail Petrochemical Company (KEMYA) Jubail Industrial City, Kingdom of Saudi Arabia • • • • • • • • Create Purchase Requisition and Service Entry sheet through SAP System Produces information by transcribing, formatting, inputting, editing, retrieving, copying, and transmitting text, data, and graphics. Conserves executive's time by reading, researching, and routing correspondence; drafting letters and documents; collecting and analyzing information; initiating telecommunications. Maintains executive's appointment schedule by planning and scheduling meetings, conferences, teleconferences and travel. Prepares reports by collecting and analyzing information. Secures information by completing data base backups. Provides historical reference by developing and utilizing filing and retrieval systems; recording meeting discussions. Maintains office supplies inventory by checking stock to determine inventory level, anticipating needed supplies, evaluating new office products, placing and expediting orders for supplies, verifying receipt of supplies. MEDICAL BILLING SPECIALIST September 10, 2012 - December 31, 2014 PRIMARY CARE MANAGEMENT SERVICES Lodlod, Lipa City Batangas, Philippines • • • • • • • • Patient Demographic Entry Coding: CPT, HCPCS & ICD-9 Charge Entry Claim Preparation, Claim Submission – Electronic or Paper Payment Posting Accounts Receivable Management: Follow-up/Appeal of claims: unpaid, underpaid & denied Patient Contact via Statements, Phone Calls & Letters Month-End Closing: Client Reports SYSTEM SUPPORT SPECIALIST April 15, 2012 – August 30, 2012 Electronic ID Technology International Incorporated 1401 Wilshire Plaza Building, 11th Annapolis St., Greenhills San Juan, Metro Manila • • • • • • • • After-sales support for CCTV (IVMS System) , BIOMETRICS (BioSTAR System) and ELECTRIC DOOR ACCESS (Matrix System). Technical support for system issues, design implementation, database control, hardware and software problems (wiring, cabling, installation, programming and testing) Provide daily monitoring to CCTV security system Report and escalate any unusual facility issue or security breaches Perform 1stlevel technical support to end-users Log, submit, follow up and monitor any incident reports Escalate unresolved problem to the next level or vendors Maintain proper operation documentation/records FLOOR ASSISTANT III WORK FORCE MANAGEMENT August 1, 2011 – March 30, 2012 Convergys Philippines Services One Evotech bldg., Nuvali Sta.Rosa, Laguna Philippines • • • • • • Ensure, in collaboration with Floor Leaders and RPM/Schedulers, accurate and timely agent schedules. Focus on real-time/Intraday agent productivity, performance exceptions and schedule adherence in collaboration with the command center. Execute system modifications (e.g., schedule updates and queue moves) and/or issue procedural notifications based on trigger events e.g., AHT, volume, attendance, etc. Coordinate trouble tickets and escalate issues as required. Work with the Floor Leader to ensure accurate and timely schedules are available to the agents Effectively use technology, tools, and other floor management resources to optimize client service levels and program economic performance. • • • • • • • Manage Intraday client, program, or line of business performance to meet or exceed contractual requirements. Be sensitive to agent's requests while balancing operational performance, contractual requirements and the needs of the business. Initiate and execute plans for unusual volume or agent availability situations including the movement of agents in CMS (queue/line management). Input Intraday scheduling exceptions as required through either Digital Solutions or IEX. Point of contact for system administration for the agents and for opening/following up on trouble tickets to ensure all tickets are resolved. Provide floor management direction through face-to-face communications, phone, and messaging applications e.g., QuickCom with agents and the command center. Track, update as needed, and report operational results. CUSTOMER SERVICE REPRESENTATIVE II PHARMACY HELP DESK November 22, 2010 – July 22,2011 Convergys Philippines Services One Evotech Bldg., Nuvali Sta. Rosa, Laguna Philippines • • • • • • • • Answer pharmacy calls pertaining to Third Party billing, provide assistance to retail pharmacies ensuring issues are identified and resolved in a timely manner. Serve as a liaison between pharmacies and insurance plan or claims processors to resolve prescription problems. Professionally handle incoming queries mainly from pharmacists regarding drug coverage, adjudication information benefit. Handle administrative override requests from Doctor's office, clients, and participants and mostly from pharmacists by reviewing request bases on administrative criteria, benefit plan design and client specific. Provide assistant to pharmacists in adjudicating the participants claim properly. Provide resolution of drug coverage issues and pro-actively address and resolve issues while maintaining accurate and complete documentation of all inquires for continuous improvement. Provides information to clients, participants, pharmacists and doctors regarding participants pharmacy benefit, drug coverage and provide accurate procedures for medication exceptions. Work collaboratively with other associates and team leads to ensure that best practices are shared. TECHNICAL SUPPORT REPRESENTATIVE DESKTOP SUPPORT I February 23, 2009 – April 7, 2010 Hewlett-Packard Technical Department Teletech – Lipa 2nd- 3RD Level, Robinson’s Place Lipa Lipa City, Batangas Philippines • • • • Greet customers in a courteous, friendly, and professional manner using agreed upon procedures. Listen attentively to customer needs and concerns; demonstrate empathy. Clarify customer requirements; probe for and confirm understanding of requirements or problem. Meet customer requirements through first contact resolution. • • • • • Confirm customer understanding of the solution and provide additional customer education as needed. Prepare complete and accurate work and update the customer file. Communicate effectively with individuals/teams in the program to ensure high quality and timely expedition of customer requests. Effectively transfer misdirected customer requests to an appropriate party. Contribute ideas on ways to resolve problems to better serve the customer and/or improve productivity. RETAIL SALES COORDINATOR Electroworld Inc. June 27, 2008 – November 26, 2008 2nd Level, SM City Lipa Lipa City, Batangas Philippines • • • • • • • • Welcomes customers by greeting them; offering them assistance. Directs customers by escorting them to racks and counters; suggesting items. Advises customers by providing information on products. Helps customer make selections by building customer confidence; offering suggestions and opinions. Documents sale by creating or updating customer profile records. Processes payments by totaling purchases; processing checks, cash, and store or other credit cards. Keeps clientele informed by notifying them of preferred customer sales and future merchandise of potential interest. Contributes to team effort by accomplishing related results as needed. PERSONAL DETAILS Age : 33 years old Date of Birth : 03 Jun 1985 Nationality : Filipino Gender : Male Marital Status : Married