JOHN KOBIE CAPARAS
Cabuyao,Laguna
Summary
Medical Biller | Team Leader leading billing teams through clean claim rates, collection targets, and denial management workflows. Coordinates coaching, workload assignment, and performance reviews while resolving escalated claims, appeals, and payer discrepancies. Uses aging reports and clearinghouse rejection data to tighten revenue recovery and keep operations aligned with HIPAA standards.
Overview
5
5
years of professional experience
Work History
Medical Biller | Team Leader
ISTA Solutions
01.2025 - 08.2026
- Track [number] daily billing tasks across charge entry, payment posting, and insurance verification.
- Lead a team of medical billers to meet daily and monthly KPIs, including Clean Claim Rates and collection targets.
- Coach billing agents through regular performance reviews and targeted training on payer policies, coding accuracy, and denial management.
- Coordinate daily workloads, assign charge entry, payment posting, and insurance verification tasks, and manage scheduling to lift team productivity.
- Analyze billing performance data, aging reports, and clearinghouse rejections to identify operational gaps and strengthen revenue recovery strategies.
- Oversee complex claims, appeals, and denial management while maintaining strict HIPAA compliance and resolving escalated discrepancies with providers, clearinghouses, and payers.
Insurance Verification Specialists
Accenture
10.2023 - 01.2025
- Verified [number] insurance verification cases daily across coverage, eligibility, deductibles, and authorization requirements.
- Reviewed and updated patient insurance records for accuracy, keeping benefit information current in the system.
- Documented verification results in system notes and reported findings clearly to the team.
- Communicated coverage details and estimated costs to patients and staff with clear, professional explanations.
- Applied Medical billing knowledge to check deductibles, co-pays, co-insurance, and prior authorization requirements.
- Maintained HIPAA compliance while handling sensitive insurance information and verification workflows.
Tech support | Senior Agent
IQORPH
03.2021 - 07.2023
- Performed remote installations and walked users through setup and troubleshooting procedures.
- Delivered accurate, complete information using the correct tools and systems during order, form, application, and request processing.
- Maintained current product knowledge and service offerings to answer customer questions accurately.
- Assessed customer needs and delivered responsive support to improve satisfaction and retention.
- Supported workload scheduling and KPI tracking by monitoring service trends and follow-up needs.
Education
SHS - Humanities and Social Science
UNIVERSITY OF PERPETUAL HELP SYSTEM DALTA
01-2020
Skills
- Medical billing
- Denial and appeals management
- Insurance verification
- KPI tracking
- Workload scheduling
- Team mentoring
- Performance coaching
- HIPAA compliance
- Aging reports
- Performance data analysis
Timeline
Medical Biller | Team Leader
ISTA Solutions
01.2025 - 08.2026
Insurance Verification Specialists
Accenture
10.2023 - 01.2025
Tech support | Senior Agent
IQORPH
03.2021 - 07.2023
SHS - Humanities and Social Science
UNIVERSITY OF PERPETUAL HELP SYSTEM DALTA