John Randolph Elnar
Quezon City
Summary
Dynamic medical billing professional with expertise in denials management at Med-Metrix. Proven ability to analyze claims issues, enhancing revenue recovery and reducing unpaid accounts. Skilled in ICD-10 coding and critical thinking, I excel in delivering accurate information and maintaining compliance, ensuring optimal service delivery in fast-paced environments.
Overview
5
5
years of professional experience
1
1
Certification
Work History
MEDICAL BILLER, DENIALS MANAGEMENT AND AR FOLLOW-UP
MED-METRIX
Pasig
03.2022 - 04.2025
- Uses the workflow system, client host system, and other tools available to them to collect payments and resolve accounts.
- Ability to analyze, identify, and trend claims issues to proactively reduce denials.
- Ensured compliance with HIPAA guidelines when handling confidential patient information.
- Investigated past due invoices and delinquent accounts to generate revenues and reduce number of unpaid and outstanding accounts.
- Follow up with payers to ensure timely resolution of all outstanding claims via phone, email, fax, or websites.
- Verified medical codes for diagnosis, treatments, procedures and supplies using ICD-10 coding system.
PROVIDER SERVICE ADVOCATE
WIPRO
Quezon City
06.2021 - 03.2022
- Answering inbound calls from healthcare providers.
- Providing accurate information about eligibility and benefits, authorization, claims, and appeals. Worked diligently and efficiently to meet the needs of numerous service users across wide-reaching geographical areas.
- Performed regular reviews of system data to identify trends or areas requiring further investigation.
OUTBOUND CUSTOMER SERVICE REPRESENTATIVE
ONE CONTACT CENTER
Pasig
07.2020 - 06.2021
- Assisting eligible U.S. citizens to see if they can qualify for SSDI benefits.
- Answered customer inquiries regarding products, services, and account information.
- Established long-lasting relationships with new and existing customers through warm, personable and knowledgeable phone interactions.
Education
Bachelor of Science - Tourism Management
Perpetual Help College of Manila
Manila04-2020
Skills
- Critical thinking
- Report writing and presenting
- Record keeping and following protocols
- Attention to detail
- Verbal and written communication
- Time management
Accomplishments
- Awarded as top agent for several months
Affiliations
- Interim trainer
- Team POC
Certification
- HIPPA Compliance
Contact References
Thon Alicante
Med-Metrix Supervisor
+639266109834
Romel Betana
Wipro Supervisor
+639360641342
Timeline
MEDICAL BILLER, DENIALS MANAGEMENT AND AR FOLLOW-UP
MED-METRIX
03.2022 - 04.2025
PROVIDER SERVICE ADVOCATE
WIPRO
06.2021 - 03.2022
OUTBOUND CUSTOMER SERVICE REPRESENTATIVE
ONE CONTACT CENTER
07.2020 - 06.2021
Bachelor of Science - Tourism Management
Perpetual Help College of Manila
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