Jose Lorenzo P. Santiago
Marikina
Summary
A highly motivated and driven individual seeking an available position to utilize years of experience and bring forth innovative ideas, analytical approach along with superior product knowledge and organizational abilities which will help me grow and as well as the company.
Overview
2026
2026
years of professional experience
Work History
Prior Authorization Representative
GeBBS
10.2024 - Current
- Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
- Verified eligibility and compliance with authorization requirements for service providers.
- Contacted insurance companies to obtain prior authorization for medical procedures and medications.
- Collaborated with healthcare providers to expedite the process of obtaining necessary medical documentation for approvals.
- Review and process prior authorization requests for MRI, CT Scan and Cardiac Vascular imaging.
- Submit clinical documents via fax to insurance companies to support medical necessity.
Billing Representative
Conifer Health Solutions
7 2022 - 05.2024
- Bill primary claims appropriately completing the billing requirements via electronic submission or paper claims including any attachment of required documentation.
- Responsible for verifying correct insurance information is loaded into demographics using VI, account notes and related accounts as resources.
- Review billing editor for all edits on UB04 and 1500 claim forms types related to charges, coding and patient information prior to billing to minimize underpayment, denials, and re-bill attempts.
- Responsible for routing accounts with needed updates for valid billing to the appropriate department or contact utilizing the workflow process.
- Notate accounts with proper activity codes for workflow back to the facilities for review of unclean claims or to the appropriate department for next steps of claim workflow.
- Flexibility in learning multiple systems and facilities as needed for billing inventory coverage.
- Expectation to complete all assigned inventory daily provided by leadership, maintaining inventory and meeting production goals.
- Maintain and abides by all billing policies and procedures, objectives, quality assurance programs and safety & compliance standards.
Sr. Associate Ops- Master Data
WNS Global Services
11.2020 - 06.2022
- Analyzing the billing of patient in accordance with the actual pathology test being taken.
- To ensure that patients are properly billed and processed in a timely manner.
- Maintain and update customer files, including name or address changes.
- Processing and recording transactions.
- Preparing weekly and month end reports.
- Performs other related duties as assigned.
Service Delivery Associate- Data Entry
SDS Healthcare Solutions Inc.
04.2019 - 11.2020
- Responsible for digitizing data for storage purposes.
- Collecting client information, maintaining an organized filing system, and reviewing data for completeness and accuracy.
- Transcribing from paper formats into computer files using manual entry.
- Enter data into appropriate fields; databases, records, and files.
- Update databases or records with new information as it becomes available.
- Protect the information and identities of customers/client.
Branch Sales And Operations Manager
Instakleen Laundromat
01.2018 - 04.2019
- Is responsible for the entire operation of a branch; from ensuring the attainment of sales goals to overseeing everyone provides excellent customer service.
- Ensure that the branch office has all the tools and infrastructure needed to keep it in working order.
- Handling sales data and reports, compensation and incentive plans, sales processes, and customer and marketing data.
- Formulating strategy, improving performance, procuring material and resources and securing compliance.
Bing Ads Back Office Support
Arvato Bertelsmann
11.2016 - 12.2017
- Create and provide day to day maintenance of campaign in AdWords.
- Research keywords as well as develop and optimize text and displays ads in conjunction with the marketing team to increase conversions and reduce costs.
- Conduct daily bid and budget optimization of campaigns.
- Analyze campaign data, interpret and synthesize results, and recommend action to optimize campaigns and keywords.
- Prepare reports to communicate campaign performance to advertisers.
- Recommend changes to website architecture, content, linking and other factors to improve Search Engine Optimization positions for target keywords.
- Implement Search Engine Optimization strategies to optimize organic search rankings.
- Perform keyword search, make Search Engine Optimization recommendations for website content and develop link building strategies.
- Contribute to advertiser's campaign performance report, using data to tell stories and provide actionable insights.
Health Advisor - Customer Service Representative
United Health Group
05.2015 - 09.2016
- Answer incoming phone calls from health care members, physician offices, clinics, and identify the type of assistance the provider needs such as benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits.
- Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff.
- Receiving, reviewing, processing, and maintaining new member group enrollment information.
- Provides support by reviewing, researching, investigating, and processing claims.
Education
Far Eastern University Manila
Our Lady Of Perpetual Help School
Marikina Catholic School
Skills
- Marketing Strategy Development
- Supply and Logistics Management
- Conflict Management
- Social Media Marketing
- Good Interpersonal Relation Skills
- Teamwork and collaboration
- Time management
- Attention to detail
- Active listening
- Adaptability and flexibility
Languages
Tagalog
English
Timeline
Prior Authorization Representative
GeBBS
10.2024 - Current
Sr. Associate Ops- Master Data
WNS Global Services
11.2020 - 06.2022
Service Delivery Associate- Data Entry
SDS Healthcare Solutions Inc.
04.2019 - 11.2020
Branch Sales And Operations Manager
Instakleen Laundromat
01.2018 - 04.2019
Bing Ads Back Office Support
Arvato Bertelsmann
11.2016 - 12.2017
Health Advisor - Customer Service Representative
United Health Group
05.2015 - 09.2016
Our Lady Of Perpetual Help School
Marikina Catholic School
Billing Representative
Conifer Health Solutions
7 2022 - 05.2024
Far Eastern University Manila
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