ANA CARSHENA AGUDELO
Healthcare Specialist
Angeles
Summary
Proactive and goal-oriented professional with excellent time management, problem-solving skills and proven ability to exceed targets and drive success in fast-paced environments. Known for reliability and adaptability, with swift capacity to learn and apply new skills. Committed to leveraging these qualities to drive team success, deliver impactful solutions and enhance organizational performance.
Overview
15
15
years of professional experience
2018
2018
years of post-secondary education
2
2
Certifications
Work History
Medical Payment Poster
La Perouse Billing LLC
12.2021 - Current
- Accepted payments and processed billing statements.
- Kept track of payment deposits from patients and insurance, reconciling details.
- Prepared payment batches.
- Conducted audits for billing cycles.
- Assessed explanation of benefits (EOBs) from insurance companies.
- Utilized various insurance portals and Availity to obtain remittance advices.
- Kept accurate billing records and reported any discrepancies to Accounting.
- Processed payments that had been received from insurance companies, Medicare, and Medicaid.
- Consistently maintained high levels of productivity, exceeding departmental goals each month.
- Assisted colleagues with complex or challenging cases, fostering a collaborative work environment focused on problem-solving and continuous improvement.
- Collaborated with billing team to resolve outstanding invoices and improve cash flow.
- Reduced payment discrepancies through meticulous attention to detail in data entry and reconciliation.
- Supported audits by providing detailed records of all posted payments and adjustments upon request.
- Maintained compliance with HIPAA regulations while handling sensitive patient information during payment posting tasks.
- Accurately posted payments and adjustments both electronically and manually.
- Managed large volumes of data efficiently and with great care on daily basis.
- Proactively identified potential underpayments from insurers and took appropriate actions to rectify discrepancies swiftly.
- Identified overpayments and processed refunds for insurance carriers and patients.
- Utilized Microsoft Excel, FirstBank, and Remittance Manager to manage invoices and payments.
Quality Analyst
TaskUs
03.2021 - 09.2022
- Conducted thorough root cause analyses on recurring defects, resulting in the implementation of effective corrective actions.
- Provided detailed reports on quality metrics to senior management, enabling informed decision-making regarding process improvements.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
- Collaborated with cross-functional teams to develop and implement targeted solutions for identified quality issues, ensuring continuous improvement.
- Analyzed quality and performance data to support operational decision-making.
- Developed and maintained quality assurance procedure documentation.
- Facilitated cross-departmental training sessions, increasing awareness and understanding of quality standards.
- Maintained up-to-date knowledge of quality assurance methodologies, applying best practices to daily tasks.
Technical Support Specialist
TaskUs
06.2020 - 03.2021
- Followed up with clients to verify optimal customer satisfaction following support engagement and problem resolution.
- Collaborated with supervisors to escalate and address customer inquiries or technical issues.
- Collaborated with cross-functional teams for complex problem-solving, leading to improved operational efficiency.
- Documented all client interactions thoroughly in the incident management system, allowing for efficient tracking of recurring issues and trends.
- Walked individuals through basic troubleshooting tasks.
- Escalated critical incidents requiring specialized expertise to appropriate departments, facilitating swift resolutions.
- Achieved high first-contact resolution rates through diligent troubleshooting efforts and comprehensive product understanding.
- Resolved diverse range of technical issues across multiple systems and applications for customers and end-users across various time zones.
- Reduced response time with effective communication skills, ensuring customers received prompt assistance.
- Served as a subject matter expert within the team for specific technologies or products, sharing knowledge with colleagues when needed.
- Explained technical information in clear terms to promote better understanding for non-technical users.
- Used ticketing systems (Zendesk) to manage and process support actions and requests.
College Instructor
Colegio De San Lorenzo
10.2019 - 04.2020
- Improved overall class performance by providing regular feedback and tailored support to individual students.
- Maintained detailed records of student attendance, participation, and academic performance for accurate reporting and evaluation purposes.
- Collaborated with colleagues on curriculum development, incorporating best practices for effective instruction and learning outcomes.
- Served on college committees focused on improving academic programs, policies, or procedures for greater institutional effectiveness.
- Administered exams and assignments to monitor student understanding and progress, implementing systems to fix blocks in comprehension or learning.
- Designed course materials that aligned with learning objectives while also meeting diverse learning needs of the student population.
- Enhanced student comprehension by utilizing a variety of teaching methods, including lectures, discussions, and group activities.
- Developed strong relationships with students through clear communication and active listening, fostering an inclusive classroom environment.
- Participated in ongoing professional development opportunities to stay current with industry trends and improve teaching skills.
- Established and maintained inclusive, collegial and collaborative culture within classroom.
- Provided students with constructive, encouraging and corrective feedback.
- Encouraged class discussions by building discussions into lessons, actively soliciting input, asking open-ended questions and using techniques to track student participation.
- Created syllabus and instructional plans for each class session in accord with stated course objectives.
- Graded quizzes, tests, homework, and projects to provide students with timely academic progress information and feedback.
- Created excitement and enthusiasm in classroom by delivering engaging subject matter.
Guidance Counselor
Colegio De San Lorenzo
10.2019 - 04.2020
- Enhanced student progress by implementing individualized counseling plans and monitoring academic performance.
- Used standardized assessments to evaluate abilities, interests and characteristics of different students.
- Assisted students in setting realistic goals, creating action plans, and tracking their achievements.
- Evaluated student needs through assessments, identifying areas for growth and providing targeted interventions when necessary.
- Organized career fairs and workshops to expose students to various professional opportunities and prepare them for post-secondary education.
- Coordinated extracurricular activities that fostered a sense of community and belonging among students, promoting a positive school culture.
- Led professional development workshops for educators on topics such as classroom management strategies or mental health awareness initiatives.
- Collaborated with teachers to develop strategies for improving student behavior and academic success.
- Actively participated in ongoing professional development opportunities to stay current with best practices in the field of school counseling.
- Served as a liaison between parents, teachers, administration, and outside agencies to ensure effective communication regarding student needs.
- Offered crisis intervention support for students experiencing emotional distress or other personal challenges.
- Maintained positive relationships with students, faculty, alumni, and administration.
- Developed and conducted workshops and seminars to educate students, faculty and parents on relevant topics in field.
- Regularly met with enrolled students to confirm success and identify problem areas.
- Advocated for students to access available resources.
- Worked with individuals to help understand and overcome personal, social or behavioral problems affecting educational situations.
Revenue Cycle Representative
Optum Global Solutions
05.2015 - 02.2019
- Collaborated with cross-functional teams to improve overall revenue cycle performance.
- Utilized EFR and EHR systems (i.e., Cerner) in accessing patient records.
- Utilized insurance portals (e.g., Availity) to verify patient eligibility, benefits, and claim status.
- Edited claims meet and satisfy billing guidelines.
- Maintained up-to-date knowledge of payer policies, regulations, and guidelines, ensuring compliance throughout the revenue cycle process.
- Reduced outstanding accounts receivable balances through diligent follow-up and effective communication with payers.
- Proactively identified underpayments by comparing remittance advice against contracted rates.
- Established strong working relationships with insurance representatives to expedite claim resolution.
- Identified root causes of claim denials through thorough analysis, implementing corrective actions for improved results moving forward.
- Created reconsideration and appeal letters to dispute discrepancies in payments.
- Reached out to insurance companies to verify coverage.
Subject Matter Expert
Convergys
01.2013 - 05.2015
- Enhanced team performance by providing expert guidance on critical projects and strategic initiatives.
- Established best practices for knowledge sharing, fostering a culture of continuous learning and improvement.
- Mentored junior team members, contributing to their professional growth and development.
- Developed comprehensive knowledge base for easy access by all team members, significantly reducing onboarding time.
- Evaluated staff performance and provided coaching to address inefficiencies.
- Generated reports detailing findings and recommendations.
- Collected, arranged, and input information into database system.
Healthcare Customer Service Representative
Convergys
02.2010 - 01.2013
- Handled inbound calls from healthcare providers, providing a breakdown of eligibility and benefits for their patients.
- Analyzed the eligibility of claims for payment based on their contracts, and communicated findings to providers.
- Coordinated with processors regarding the validity of these claims.
- Enhanced customer satisfaction by resolving issues promptly and professionally.
- Established trust with clients through clear communication, patience, and understanding their unique challenges fully before offering solutions tailored to their needs.
- Managed high call volume while maintaining a courteous and professional demeanor.
- Adapted quickly to changes in company policies or procedures ensuring consistency in delivering accurate information to customers.
- Increased customer retention rates by providing exceptional problem-solving skills and personalized solutions.
- Developed rapport with customers, fostering long-term relationships and repeat business.
- Monitored quality assurance metrics regularly, identifying opportunities for personal growth and development within the role.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Responded proactively and positively to rapid change.
- Maintained up-to-date knowledge of product and service changes.
Education
Bachelor of Science - Psychology
Colegio De San Lorenzo
Quezon City, Metro Manila, Philippines04-2017
Skills
MS Office Suite
undefinedCertification
Board Passer, October 2017
Timeline
Medical Payment Poster
La Perouse Billing LLC
12.2021 - Current
Quality Analyst
TaskUs
03.2021 - 09.2022
Technical Support Specialist
TaskUs
06.2020 - 03.2021
College Instructor
Colegio De San Lorenzo
10.2019 - 04.2020
Guidance Counselor
Colegio De San Lorenzo
10.2019 - 04.2020
Revenue Cycle Representative
Optum Global Solutions
05.2015 - 02.2019
Subject Matter Expert
Convergys
01.2013 - 05.2015
Healthcare Customer Service Representative
Convergys
02.2010 - 01.2013
Bachelor of Science - Psychology
Colegio De San Lorenzo
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