Boby Sallao Cuevas
San Jose del Monte City,Bulacan
Summary
Detail-oriented Medical Billing Specialist with 10 years in healthcare, including 4 years in billing, coding, and revenue cycle management. Expertise in CMS-1500 and UB-04 claims processing, insurance verification, prior authorisations, payment posting, and denial management. Proficient in ICD-10, CPT, HCPCS coding, and HIPAA-compliant workflows within EHR systems like Epic and Cerner.
Overview
13
13
years of professional experience
Work History
System Administrator/ Production Warehouse and Logistics Operations
GE VERNOVA / LM WINDPOWER CANADA
Gaspe, Quebec
12.2023 - 07.2026
- Ensured completion and accuracy of Production Orders prior to submission to Finance team for closing.
- Managed and maintained Production Order databases within the system for accurate record-keeping.
- Updated missing material quantities and counts in the system (Oracle / Axapta 2012 / ERP).
- Performed picking of materials in the system to ensure accurate records are kept.
- Coordinated with Quality and Data Analyst Team to complete Inspection Lists required for work order closures.
- Coordinates with Global team, specifically the IT team, on resolving system and application issues.
- Oversaw access management for new team members, ensuring secure username and password setup.
- Reports directly to the Operations Manager and Plant Manager.
Fiber Glass Technician / Operator
GE VERNOVA / LM WINDPOWER CANADA
Gaspe, Quebec
07.2023 - 12.2023
- Assigned in production as a fiberglass laminator/technician for 107m wind blades/turbine.
- Handled fiberglass lay-up (molding), injection, and infusion of fiberglass and resin.
- Oversaw assembly of 107m wind blades/turbine before delivery, ensuring completion of required accessories, materials, and components.
- Contributed to finishing department by assisting with final product quality checks to ensure standards were met.
- Driving and operation of lifting machineries such as forklifts, scissor lifts, and manlifts.
- Reported to operation team leader and production supervisor, ensuring clear communication on tasks.
- Maintained cleanliness of work station and performed basic tool upkeep to support operational efficiency.
Remote Medical VA / Medical Biller
FLORIDA-VALLEY MEDICAL PAIN AND WELLNESS MN- OUSTA-ZOOMPLOYEE PHILIPPINES
01.2022 - 08.2023
- Translate medical procedures and diagnoses into standardized codes (like ICD-10 and CPT) to be generated and submitted to insurance claims payers including but not limited to; Private insurance carriers, Medicaid, and Medicare.
- Processed insurance claims, ensuring timely submission and maximising approval rates
- Review rejected or denied claims, correct errors, add modifiers, and file appeals to secure proper reimbursement.
- Managed denied claims by reviewing and correcting errors, filing appeals to secure appropriate reimbursements
- Create and send billing statements, answer patient inquiries, and set up payment arrangements for remaining balances.
- Generated patient billing statements and addressed inquiries, facilitating clear communication regarding outstanding balances
- Record incoming payments from insurance companies and patients, matching them to specific invoices.
- Ensured compliance with HIPAA regulations
- Maintain strict adherence to privacy laws like HIPAA regarding patient health information.
Remote Medical VA / Medical Biller
MBH SERVICES LLC NY USA - BRUNTWORK PHILIPPINES
03.2019 - 11.2021
- Translate ABA medical procedures and diagnoses into standardized codes (like ICD-10 and CPT) to be generated and submitted to insurance claims payers including but not limited to; Private insurance carriers, Medicaid, and Medicare.
- Processed insurance claims to facilitate accurate and prompt payment from insurers
- Resolved denied claims to ensure timely reimbursement for services rendered
- Reviewed and corrected rejected claims, added modifiers, and filed appeals to secure proper reimbursement
- Record incoming payments from insurance companies and patients, matching them to specific invoices.
- Create and send billing statements, answer patient inquiries, and set up payment arrangements for remaining balances.
- Search on medical insurance including Medicaid and Medicare portal for forms and information needed and update any process or documents.
- Ensured compliance with healthcare regulations
- Maintain strict adherence to privacy laws like HIPAA regarding patient health information.
Billing, Claims and Collections/ RCM Representative
UNITED HEALTH GROUP-OPTUM GLOBAL SOLUTIONS
Quezon City
10.2015 - 02.2019
- Managed and resolved denied claims to secure proper reimbursements.
- Review rejected or denied claims, correct errors, add modifiers, and file appeals to secure proper reimbursement.
- Processed and managed claims for hospitals and clinics to ensure timely payments.
- Assisted hospitals, clinics, and facilities in collecting and processing claims and accounts receivable for insurance companies and patients.
- Managed patient billing processes to ensure accuracy and timeliness of payments.
- Created and sent billing statements, addressed patient inquiries, and established payment arrangements for outstanding balances.
- Contacted payer and patient to clarify billing issues.
- Ensured compliance with HIPAA regulations to protect patient health information.
- Maintain strict adherence to privacy laws like HIPAA regarding patient health information.
Customer Service Representative Member Services
BCBS MEMBER SERVICES - CONCENTRIX PHILIPPINES
Quezon City
10.2013 - 09.2015
- Managed inquiries from patients or medical staff via phone, chat, or email, ensuring timely and accurate responses.
- Answer Inbound Calls:
- Conduct thorough verification of patient insurance coverage and eligibility details.
- Explain the patients current/active health insurance(s) coverage.
- Manage Appointments:
- Schedule, reschedule, or cancel medical appointments.
- Handle Claims and Billing:
- Clarified billing statements, account balances, and claim statuses to enhance understanding and resolution.
- Maintain and update patient records with current insurance provider information.
- Update patients coordination of benefits.
- Documented customer interactions in computer databases and electronic health record systems, ensuring accuracy and compliance.
- Maintain Compliance:
- Follow strict data privacy rules and regulations (HIPAA), such as keeping patient data secure.
Education
B.S. - Customs Administration
Philippine Maritime Institute (PMI) Colleges, Manila College of Customs Administration
Santa Cruz01-2005
Polytechnic University of the Philippines (PUP), Bataan Laboratory High school
Mariveles01-1997
Elementary Education
Secondary Education Antonio G. Llamas Elementary School, Bataan Intermediate School
Mariveles01-1994
Skills
- Oracle ERP expertise
- Oracle ERP administration
- Database management
- Computer proficiency
- Microsoft 365 (Word, Excel, PowerPoint, Outlook)
- Google Workspace (Docs, Sheets, Slides, Gmail)
- Zoom, Microsoft Teams, Slack, and Trello
- Google Drive, Dropbox, OneDrive, and basic SQL or Tableau for data visualisation
- Remote collaboration
- Verbal and written communication
- Adaptable scheduling
- High-pressure adaptability
REFERENCES:
- Patrick, Plourde, Warehouse Supervisors, GE Vernova, Gaspe, Quebec, Canada, Jonathan Jean
- Areen, Combalicer, Manager, Optum Global Solutions Philippines, Quezon City, Philippines, Assistant
- Jayjay, Bondoc, Manager, Concentrix, Quezon City, Philippines, Assistant
Timeline
System Administrator/ Production Warehouse and Logistics Operations
GE VERNOVA / LM WINDPOWER CANADA
12.2023 - 07.2026
Fiber Glass Technician / Operator
GE VERNOVA / LM WINDPOWER CANADA
07.2023 - 12.2023
Remote Medical VA / Medical Biller
FLORIDA-VALLEY MEDICAL PAIN AND WELLNESS MN- OUSTA-ZOOMPLOYEE PHILIPPINES
01.2022 - 08.2023
Remote Medical VA / Medical Biller
MBH SERVICES LLC NY USA - BRUNTWORK PHILIPPINES
03.2019 - 11.2021
Billing, Claims and Collections/ RCM Representative
UNITED HEALTH GROUP-OPTUM GLOBAL SOLUTIONS
10.2015 - 02.2019
Customer Service Representative Member Services
BCBS MEMBER SERVICES - CONCENTRIX PHILIPPINES
10.2013 - 09.2015
B.S. - Customs Administration
Philippine Maritime Institute (PMI) Colleges, Manila College of Customs Administration
Polytechnic University of the Philippines (PUP), Bataan Laboratory High school
Elementary Education
Secondary Education Antonio G. Llamas Elementary School, Bataan Intermediate School