Anne Nickole Paje
Summary
Proactive Medical Biller and Health Insurance Specialist with extensive experience in verifying insurance eligibility, resolving denied claims, and managing appeals. Skilled in claims processing, accounts receivable management, and maintaining accurate medical records. Known for ensuring compliance and delivering exceptional customer service to advance healthcare operations. Detail-oriented professional with focus on deadlines and skilled in handling medical billing without errors. Confident Medical Biller knowledgeable in data confidentiality and privacy practices when reviewing patient information.
Overview
6
6
years of professional experience
Work History
Medical Biller Specialist
Peoples Healthcare LLC
04.2020 - 07.2024
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Filed and updated patient information and medical records.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Collected payments and applied to patient accounts.
- Posted payments and collections on regular basis.
- Accurately entered patient demographic and billing information in billing system to enable tracking history and maintain accurate records.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
Health Insurance Specialist
Concentrix
02.2018 - 03.2020
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Performed needs analysis to obtain information required to make appropriate health insurance product recommendations.
- Verified insurance coverage by telephone and online to guarantee proper reimbursement of benefits and estimate patients' financial responsibilities.
- Ensured compliance with state regulations regarding health insurance policies, diligently monitoring updates to laws and guidelines.
- Educated clients about health insurance coverage options, benefits and costs.
- Educated clients on insurance policies and procedures.
Education
Bachelor of Science - Information Technology
AMA Computer College
Malolos, Province Of Bulacan, Philippines05.2017
Skills
- Medical Billing Software Proficiency
- HIPAA compliance awareness
- Claims Processing Proficiency
- Accounts receivable management
- Claim Submission Efficiency
- Insurance claims processing
- Teamwork and Collaboration
- Customer Service
Timeline
Medical Biller Specialist
Peoples Healthcare LLC
04.2020 - 07.2024
Health Insurance Specialist
Concentrix
02.2018 - 03.2020
Bachelor of Science - Information Technology
AMA Computer College
Similar Profiles
Sherajane AntipasadoSherajane Antipasado
Medical Biller at Peoples Healthcare LLCMedical Biller at Peoples Healthcare LLC
MAXINE B. PASIAMAXINE B. PASIA
Medical Biller at Peoples Healthcare LLcMedical Biller at Peoples Healthcare LLc
Carlee HeauslerCarlee Heausler
Inpatient Authorization Nurse at Peoples Health Network/United HealthcareInpatient Authorization Nurse at Peoples Health Network/United Healthcare