Job Search Status
Open to workDesired start date: Immediately
Open To Work
Aljen C. Ylanan
Liloan, Province Of Cebu
Work Preference
Summary
Medical billing professional with deep expertise in managing patient billing and insurance claims. Strong background in coding, account reconciliation, and compliance with healthcare regulations. Known for collaborating effectively with teams and adapting to changing needs to achieve optimal results. Reliable and detail-focused, ensuring accurate and timely processing of financial information.
Overview
13
13
years of professional experience
Work History
Medical Billing Specialist
Rutherford and Hacienda Enterprises Inc. (Outsource Company of St. Joseph Medical Managers)
Oakridge Business Park, A.S. Fortuna Street, Banilad, Mandaue City, Cebu
03.2014 - Current
- Responsible for processing health insurance claims for doctors' offices, hospitals, and other healthcare facilities.
- Responsible for translating physician’s reports into useful medical codes.
- Reviewing accounts for insurance of patient follow-up.
- Reviewing patient bills for accuracy and completeness and obtaining any missing information.
- Calling insurance companies regarding any discrepancy in payments if needed.
- Researching and appealing denied claims.
- Answering all patient or insurance telephone inquiries for all accounts.
- Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
- Checking each insurance payment for accuracy and compliance with contract discount.
- Perform posting charges and completion of claims to payers in a timely fashion.
- Work claims and claim denials to ensure maximum reimbursement for services provided.
- Collects delinquent accounts by establishing payment arrangements with patients, monitoring payments, following up with patients when payment lapses occur.
- Supervises all staff for all accounts.
Credit & Collections Supervisor
Vicsal Development Corp (Super Metro Bogo)
Bogo City, Cebu
07.2013 - 01.2014
- Responsible in all purchase order and credit card concerns.
- Assigned in checking, editing, and reviewing statement of accounts of each guarantor.
- Monitored daily sales of Credit Department.
- Supervised all personnel of Credit Department.
- Customer Service trainer
Education
Bachelor of Science - Management Accounting
University of San Jose-Recoletos
Corner P. Lopez And Magallanes Streets, Cebu City01-2013
Secondary - undefined
San Remigio National High School
San Remigio, Cebu01-2009
Primary - undefined
Bogo Central School 1
Cogon, Bogo City, Cebu01-2005
Skills
- ICD-10 proficiency
- Claims processing proficiency
- HIPAA compliance
- Patient confidentiality practices
- Electronic health records experience
- Medical terminology
- Data entry efficiency
- Medical coding expertise
- Accounts receivable management
- CPT coding
- Insurance verification mastery
- Healthcare revenue cycle management
- Denial resolution strategies
- Medicare and medicaid regulations
- Payment posting accuracy
- Claim submission procedures
- Billing and collection procedures
- CMS-1500 billing forms
- Patient account analysis
- Insurance verification
- Commercial and private insurance
- Knowledgeable in different medical billing software such as NueMD, Veradigm, AdvanceMD, US Intellect, Practice Fusion, Office Ally, Epic, Crystal, NextGen, Trizetto
- CPT code modifiers
- Billing codes
- Procedure coding
Timeline
Medical Billing Specialist
Rutherford and Hacienda Enterprises Inc. (Outsource Company of St. Joseph Medical Managers)
03.2014 - Current
Credit & Collections Supervisor
Vicsal Development Corp (Super Metro Bogo)
07.2013 - 01.2014
Secondary - undefined
San Remigio National High School
Primary - undefined
Bogo Central School 1
Bachelor of Science - Management Accounting
University of San Jose-Recoletos