JERRIE AHNE FERNANDEZ
Baras
Summary
Detail-driven and patient-focused Medical Virtual Assistant with 13 years of combined experience in healthcare BPO and virtual medical support. I bring a deep understanding of healthcare workflows, medical terminology, and front-line administrative operations. Known for blending tech-savvy efficiency with a human touch, I specialize in streamlining schedules, improving patient communication, and supporting clinicians remotely with empathy and precision. Ready to elevate virtual care delivery as a trusted extension of your medical team.
Overview
13
13
years of professional experience
1
1
Certificate
Work History
MVA ELIGIBILITY SPECIALIST
SUNRISE HEALTH SERVICES AZ
03.2024 - 05.2025
- Verify patient insurance coverage and eligibility through online portals or direct communication with insurance providers.
- Accurately document insurance benefits, including co-pays, deductibles, coinsurance, and pre-authorization requirements.
- Obtain prior authorizations and referrals as required by insurance plans to ensure timely medical service delivery.
- Coordinate with patients to update and confirm insurance and demographic information.
- Collaborate with billing and coding departments to resolve insurance claim issues and denials.
- Maintain up-to-date knowledge of insurance guidelines and industry regulations (Medicare, Medicaid, private plans).
- Process incoming insurance verifications in a timely manner to prevent service delays or billing issues.
- Ensure compliance with HIPAA and all privacy laws during insurance and patient data handling.
- Assist front-office and clinical staff by clarifying insurance questions and verifying changes in patient policies.
- Monitor and follow up on outstanding verifications and communicate updates with appropriate departments.
- Assessed client eligibility for healthcare programs, ensuring compliance with regulatory guidelines.
- Coordinated with healthcare providers to gather necessary information for eligibility determinations.
CREDIT REFUND QUALITY ANALYST - ACCOUNTS RECEIVABLE OPERATIONS SUPERVISOR
MED-METRIX PHILIPPINES
12.2021 - 03.2025
- Assisted in creating and maintaining Standard Operating Procedures (SOPs) and process documentation.
- Partnered with operations and leadership to identify process gaps and develop improvement strategies.
- Participated in calibration sessions to ensure quality standards and process consistency across teams.
- Reviewed account history, remittance advices (EOBs), and payment postings to prevent inappropriate refunds or duplicate payments.
- Audited patient and payer refund requests to validate overpayments and ensure accurate credit balance resolution.
- Supervised a team of A/R specialists responsible for claims follow-up, denial resolution, and cash posting accuracy across multiple payers.
- Monitored and analyzed A/R aging reports, ensuring timely collection and reduction of outstanding receivables.
- Oversaw daily operations, including work allocation, productivity tracking, and team performance reviews.
MVA APPOINTMENT SETTER
APEX PHYSIO IN BERMUDA
01.2023 - 03.2024
- Provided virtual administrative support to physicians and healthcare staff, handling appointment scheduling, patient inquiries, and follow-ups.
- Managed electronic medical records (EMR) and ensured timely updates to patient charts, lab results, and referral documentation.
- Responded to patient emails and calls and provide real-time scheduling assistance to patients requesting same-day, next-day or future appointments.
- Managed provider calendars, optimized scheduling slots, and minimized appointment gaps and cancellations.
- Primary contact for inbound patient calls
- Followed up on no-shows and cancellations, rescheduling as needed to maintain clinic productivity.
HEALTHCARE BILLING SPECIALIST - SME - TEAMLEADER
HINDUJA GLOBAL SOLUTIONS
04.2012 - 12.2021
- Handled inbound and outbound calls related to eligibility, benefits, prior authorizations, and claims adjudication.
- Analyzed claims processing, payments, provider contracts, and denial management to determine resolution paths.
- Processed real-time claims and provided timely determinations in accordance with payer guidelines and compliance standards.
- Reviewed appeals, reconsiderations, and associated medical records for further investigation and resolution.
- Maintained up-to-date knowledge of payer policies, CMS guidelines, and HIPAA compliance.
- Supervised a team of healthcare representatives ensuring daily, weekly, and monthly performance targets (quotas) were met.
- Provided coaching, performance evaluations, and professional development guidance to enhance team capabilities.
- Supported new hire and ongoing training sessions, focusing on both system navigation and policy interpretation.
- Assisted in creating and maintaining Standard Operating Procedures (SOPs) and process documentation.
Education
Bachelor of Science - Human Resource Management
Tomas Claudio College
01.2014
Master’s Degree - Strategic Human Resource Management
University of Sto Tomas
01.2018
Skills
- Customer Service
- Problem-Solving
- Time Management
- Communication
- Team Collaboration
- CPT, ICD-10, and HCPCS Coding
- Detail-Oriented
- HIPAA Compliance & Medical Terminology
Certification
- HIPAA CERTIFICATION
- Professional in Human Resources (PHR)
- Professional in Learning and Performance (CPLP)
LANGUAGE
ENGLISH
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
MVA ELIGIBILITY SPECIALIST
SUNRISE HEALTH SERVICES AZ
03.2024 - 05.2025
MVA APPOINTMENT SETTER
APEX PHYSIO IN BERMUDA
01.2023 - 03.2024
CREDIT REFUND QUALITY ANALYST - ACCOUNTS RECEIVABLE OPERATIONS SUPERVISOR
MED-METRIX PHILIPPINES
12.2021 - 03.2025
HEALTHCARE BILLING SPECIALIST - SME - TEAMLEADER
HINDUJA GLOBAL SOLUTIONS
04.2012 - 12.2021
Master’s Degree - Strategic Human Resource Management
University of Sto Tomas
Bachelor of Science - Human Resource Management
Tomas Claudio College
Quote
There is a powerful driving force inside every human being that, once unleashed, can make any vision, dream, or desire a reality.
Tony Robbins
References
Alastair, Ko Digma, Senior Operations Manager, akdigma@gmail.com, 0916 775 8667
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