Gemalyn Betis
Manila,00
Summary
Effective Medical Claims Processor with strong background building rapport with providers to discuss claim status or claim denials. Driven performer equipped to handle multiple administrative tasks effectively. Exemplary worker with highly investigative skills when processing claims.
Overview
14
14
years of professional experience
Work History
Medical Claims Specialist
KMC MAG Solution Inc. (Healthrise)
06.2023 - 06.2024
- Processed and followed up on daily claims transactions to verify remittance; analyzed denials and implemented effective solutions that reduced denial rates by 25% and improved claim resolution times by 40%.
AR Follow Up Analyst
ARMO PHIL INC.(MED_METRIX)
01.2022 - 06.2023
- Processed daily claims transactions and followed up for remittance verification; identified and resolved denials, reducing claim processing time by 30% and recovering 95% of previously denied claims.
Provider Services (Health Care)
Legato Health Technologies
10.2021 - 01.2022
- Provide accurate information about the claim's denial and benefit to providers about the claim's status and the member's eligibility.
Financial and Telco
Teleperformance Inc. Ayala
12.2019 - 08.2021
- Giving you information on the status of your account and ensuring a faster resolution for your balances, payments, and connections.
Sales Representative
MP3 Games Incorporated
07.2012 - 01.2014
- I am responsible for marketing the item, the product, and direct contact with the customer to ensure good service and assistance.
Cashier
Sea Oil Phil. Inc.
02.2010 - 07.2011
- Ensured precise, secure customer payment computations and accurate billing by implementing new verification protocols, which reduced billing errors by 45% and increased transaction security by 30%
Education
Collage Graduate - BSBA major in Marketing
Informatics International Collage
05.2009
Skills
- Proficient in Microsoft Word, QuickBooks, Excel, and PowerPoint
- Familiar with Solution Central, M Power, EPIC, and Health Quest
- Ability to work effectively with others and demonstrates active willingness
- Self-motivated and good communicator
- Being an active listener, managing your time, and learning new skills
- Knowledgeable about Payer Portals such as Navi Net, Availity, UHC Portal UMR and WPS
Timeline
Medical Claims Specialist
KMC MAG Solution Inc. (Healthrise)
06.2023 - 06.2024
AR Follow Up Analyst
ARMO PHIL INC.(MED_METRIX)
01.2022 - 06.2023
Provider Services (Health Care)
Legato Health Technologies
10.2021 - 01.2022
Financial and Telco
Teleperformance Inc. Ayala
12.2019 - 08.2021
Sales Representative
MP3 Games Incorporated
07.2012 - 01.2014
Cashier
Sea Oil Phil. Inc.
02.2010 - 07.2011
Collage Graduate - BSBA major in Marketing
Informatics International Collage