Angielyn A
Angono, Province Of Rizal
Summary
Dynamic Medical Claims Analyst with a proven track record at Med-Metrix, adept in claims processing proficiency and exceptional customer service. Mastered HIPAA compliance, enhanced claim resolution efficiency, and fostered provider relations. Known for critical thinking and adaptability, significantly improved processing workflows and customer satisfaction through innovative solutions and effective communication.
Overview
5
5
years of professional experience
Work History
Medical Claims Analyst
Med- Metrix
12.2022 - 09.2024
- Achieved successful resolutions on disputed claims through effective collaboration between internal departments such as legal counsel and clinical experts.
- Ensured accurate payments by meticulously reviewing medical records, invoices, and supporting documentation.
- Enhanced claim processing efficiency by implementing automated workflows and streamlining procedures.
- Improved customer satisfaction by resolving complex medical claims in a timely and professional manner.
- Supported management''s decision-making process by providing insightful reports analyzing historical claims data.
- Negotiated with health care providers to reach mutually beneficial agreements on contested claim amounts.
- Demonstrated a commitment to continuous improvement by actively seeking out opportunities for process optimization within the Medical Claims Analyst role.
- Collaborated with healthcare providers to clarify billing discrepancies and negotiate payment terms.
Healthcare Customer Service Representative
Concentrix
03.2020 - 11.2022
- Followed up on patient feedback to ensure satisfaction with care.
- Processed patient registration and verified necessary information.
- Educated patients on available resources and support services.
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
- Educated customers about billing, payment processing and support policies and procedures.
Education
Bachelor of Science - Bachelor of Science in Human Resource Management
University Of Makati
Makati City, Metro Manila, Philippines09-2023
Skills
- Claims processing proficiency
- HIPAA compliance
- Training and mentoring
- Medical terminology
- Insurance policies
- Customer service
- Medical record review
- Insurance claims processing
- Quality assurance checks
- Telephone etiquette
- Provider relations
- Insurance claims
- Inpatient records coding
- ICD codes
- Claims investigation
- Critical thinking
- Organizational skills
- Team collaboration
- Effective communication
- Adaptability and flexibility
Timeline
Medical Claims Analyst
Med- Metrix
12.2022 - 09.2024
Healthcare Customer Service Representative
Concentrix
03.2020 - 11.2022
Bachelor of Science - Bachelor of Science in Human Resource Management
University Of Makati
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