Hi, I’m
JHANENE MAGANA
Healthcare Virtual Assistant
Novaliches Quezon City
Summary
Provider Service Advocate with 4 years of experienced at UnitedHealthcare. I have worked with providers with claims submission, claims payment, claim rejection and claims denial. I also help them reprocessing the claim if needed. I've been also a Referral coordinator who manages patient referrals, arranges appointments, tracking pending referrals to avoid delays in patient care.
Overview
10
years of professional experience
Work History
Optum Global Solutions
Provider Service Advocate
09.2021 - 10.2025
Job overview
- Answer incoming calls from healthcare providers regarding benefits, eligibility, authorizations and claims.
- With knowledge in HIPAA guidelines
- Checking patient eligibility and benefits before services are rendered.
- Checking and providing claim status such as claim payment details, claim denials, claim rejections and claim escalations.
- Checking appeals for denied claims and submitting manual review request or escalation if needed.
- Guide sellers on resolving policy violations, improving metrics, and appealing suspensions.
- Troubleshoot issues with Seller Central tools, APIs, and integrations.
- Manage listing, tracking shipments and providing real time assistance
Optum Global Solutions
Assistant Team Lead
01.2022 - 01.2025
Job overview
- Track team performance (KPIs such as Average Handling Time, Release rate and provider satisfaction).
- Auditing random calls to check if complete attributes were followed with accurate information.
- Encourage professional growth and motivate team members.
Virgen De Guadalupe De Novaliches School
English Teacher
06.2019 - 07.2021
Job overview
- Preparing lessons and projects to complete the learning objectives.
- Adapting teaching methods and materials to meet the interests and learning style of students.
Concentrix Daksh Services Philippines Corporation
Customer Care Specialist
07.2016 - 06.2019
Job overview
Referral coordinator
11.2025 - 07.2026
Job overview
- Receive referral request from physician.
- Verify patient insurance coverage and referral requirements.
- Schedule patient with the appropriate specialist.
- Document all steps in EMR/EHR system.
Education
NATIONAL POLYTECHNIC COLLEGE OF SCIENCE AND TECHNOLOGY
Bachelor of Secondary Education from Major in English
01.2019
University Overview
Skills
- Familiarity with HIPAA
- Billing standards
- Healthcare systems
- Insurance policies
- Medical terminology
- Customer service
- EMR/EHR systems
- Gastro ModMed
- Office Ally
- ICANotes
- Genesys Workspace
- Citrix Workspace
- Google Workspace
- LivePerson
- Power BI
- DOC360
- Knowledge Library (KL)
- I-CUE
- ATS
- ETS
- Provider Notification Lists (PNL)
- State Specific Grids (SSG)
- CMSgov
- Canva
Tools Used
Tools Used
- Gastro ModMed
- Office Ally
- ICANotes
- Genesys Workspace
- Citrix Workspace
- Google Workspace
- LivePerson
- Power BI
- DOC360
- Knowledge Library (KL)
- I-CUE
- ATS and ETS
- Provider Notification Lists (PNL)
- State Specific Grids (SSG)
- CMS.gov
- Canva
Timeline
Referral coordinator
11.2025 - 07.2026
Assistant Team Lead
Optum Global Solutions
01.2022 - 01.2025
Provider Service Advocate
Optum Global Solutions
09.2021 - 10.2025
English Teacher
Virgen De Guadalupe De Novaliches School
06.2019 - 07.2021
Customer Care Specialist
Concentrix Daksh Services Philippines Corporation
07.2016 - 06.2019
NATIONAL POLYTECHNIC COLLEGE OF SCIENCE AND TECHNOLOGY
Bachelor of Secondary Education from Major in English