JENNELYN TUAZON
Summary
Experienced and dependable general worker with a proven track record of efficiently completing tasks in various settings. Skilled in manual labor, equipment operation, and maintaining a clean and organized workspace. Safety-conscious with a strong work ethic and the ability to adapt to different environments. Ready to contribute to a dynamic team and make a positive impact.
Overview
6
6
years of professional experience
Work History
Senior Representative II
Eviden Company
03.2024 - 01.2025
- Insurance Verification for Eligibility and Benefits
- Validation of Healthcare Provider's Network
- Verification for Coordination of Benefits
- Generation Prior Authorization
- Collaboration with Healthcare Providers to collect necessary information
- Monitoring and Follow-ups
- Investigates claims denials
- Comparing the CPT codes billed and the billed amount by Physician and Facility
- Resolving insurance and billing related issues.
- Reviewing and analyzing health care provider claims
- Identifying trends and issue with the revenue cycle process
Patient Services Representative I
CONIFER GBC Solutions
06.2022 - 03.2024
- Verification Eligibility & Benefits
- Securing Pre-certification/Authorization
- Confirmation of Coordination of Benefits
- Document all call details per standard operation procedure
- Interact with Healthcare Providers for needed information via phone, email and Fax
- Monitoring and Follow-ups with Insurance companies
Provider Service Advocate
WIPRO PHILIPPINES
05.2019 - 06.2022
- Helping Health care Provider's inquiries about claims
- Explaining claims denials
- Assisting Providers how to reconsider the claims submitted
- Explaining the Explanation of Benefits to the Providers
- Giving out details the Benefits and Eligibility of the member's Insurance
- Securing Prior Authorization over the phone/Portal
- Helping patient about Appeals status and submission
Skills
- Telephone etiquette
- Proficient in [technology]
- Project management
- Customer rapport
- Project oversight
- Technical aptitude
Timeline
Senior Representative II
Eviden Company
03.2024 - 01.2025
Patient Services Representative I
CONIFER GBC Solutions
06.2022 - 03.2024
Provider Service Advocate
WIPRO PHILIPPINES
05.2019 - 06.2022
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