HAZEL Dumagan
Digos City
Summary
Experienced Medical Biller/Credentialing Specialist/Payment Posting with nearly 1 year of expertise in managing Urgent Care medical coding and billing responsibilities. Demonstrated ability to efficiently handle tasks with precision and attention to detail. Skilled in collaborating with insurance providers to streamline claims procedures. Proficient in accurately inputting procedure and diagnosis codes into billing systems to facilitate invoice generation.
Overview
7
7
years of professional experience
4
4
years of post-secondary education
4
4
Certifications
2
2
Languages
Work History
Medical Biller/Credentialing/Payment Posting
Urgent Care clinic
Maryland
07.2024 - 04.2025
- Managed and processed medical claims, ensuring accuracy and timely reimbursement from insurance providers.
- Coordinated credentialing and recredentialing for healthcare providers, ensuring all certifications were current and compliant.
- Collaborated with insurance companies to resolve billing and credentialing discrepancies, enhancing claim approval rates.
- Maintained comprehensive knowledge of payer policies and changes in billing regulations to ensure compliance.
- Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Filed and updated patient information and medical records.
- Reviewed patient diagnosis codes to verify accuracy and completeness.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Posted payments and collections on regular basis.
- Delivered timely and accurate charge submissions.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Collected payments and applied to patient accounts.
- Organized filing system for patient records, expediting access to essential documents when needed.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Streamlined billing processes by implementing efficient procedures to improve accuracy and reduce errors.
- Adhered to established standards to safeguard patients' health information.
- Prepared billing statements for patients and verified correct diagnostic coding.
Branch Sales Supervisor
Personal Collection DSI
09.2021 - 07.2024
- Led Sales Teams: Supervised and motivated sales teams to achieve and exceed targets.
- Developed Strategies: Created and implemented effective sales and marketing strategies.
- Managed Client Relationships: Cultivated strong client relationships to enhance customer satisfaction and retention.
- Coordinated Marketing Efforts: Aligned branch sales activities with marketing initiatives to maximize impact.
- Analyzed Performance: Monitored and analyzed sales performance metrics to drive continuous improvement.
- Trained Staff: Provided training and development to sales and marketing personnel.
- Market Analysis: Conducted market research to identify opportunities and adapt strategies accordingly.
Human Resources Specialist
Franklin Baker Company of the Philippines
05.2018 - 09.2021
- Payroll & Benefits Management: Administered payroll, compensation, and benefits programs.
- Government Remittances: Ensured timely and accurate government remittances and compliance.
- Motorpool Coordination: Oversaw motorpool operations and maintenance.
- Service Provider Management: Managed relationships with service providers to ensure quality service.
- Administrative Services: Handled employee discipline and maintained administrative functions.
- Customer Satisfaction: Ensured 100% customer satisfaction while achieving key performance indicators (KPIs) such as sales and CER (Customer Experience Rating).
- Knowledgeable in relevant software for bookkeeping, HR management, CRM, and reporting.
- Leadership: Strong leadership skills for supervising teams, training staff, and driving performance.
- Multi-tasking: Ability to handle diverse responsibilities and manage multiple projects simultaneously.
- Financial Acumen: Understanding of financial principles, including payroll, compensation, and budgeting.
- Cold Calling: Experienced in initiating contact with potential clients and handling billing and collections through outbound calls.
- Organizational Skills: Efficient in organizing tasks, maintaining records, and managing operational processes.
Education
Bachelor of Science - Accountancy
COR JESU COLLEGE
Digos City, Philippines 06.2014 - 04.2018
Skills
Effective communication
Effective time management
Thoroughness in review processes
Skillful dispute resolution
Analytical problem-solving
Claims management expertise
Skilled in utilizing Codonix, EBS, and insurance platforms
Billing and collection management
Clerical support
Multitasking and organization
Teamwork and collaboration
Knowledge of HIPAA standards
CMS-1500 billing forms
ICD-10 coding proficiency
Claims processing
Certification
Quickbooks, 11/01/23
Timeline
Medical Biller/Credentialing/Payment Posting
Urgent Care clinic
07.2024 - 04.2025
Branch Sales Supervisor
Personal Collection DSI
09.2021 - 07.2024
Human Resources Specialist
Franklin Baker Company of the Philippines
05.2018 - 09.2021
Bachelor of Science - Accountancy
COR JESU COLLEGE
06.2014 - 04.2018