KISS MAE R. MORATA
Senior Insurance Coordinator
Legazpi, Province Of Albay
Summary
Insurance Coordinator and Registered Nurse: Republic of the Philippines, License No. 0744546.
A passionate, highly skilled health care professional, with broad-based expertise, demonstrated success in nursing, insurance work, and care coordination. Can easily adapt in a new and different working environments
Overview
12
12
years of professional experience
4
4
years of post-secondary education
3
3
Certifications
Work History
Insurance Expert Cum Receptionist
Health and Happiness Clinic
03.2022 - 03.2025
- Verified patient insurance coverage and benefits.
- Reviewed and managed insurance claims to ensure accuracy and compliance.
- Resolved discrepancies and addressed claim denials.
- Communicated with insurance companies to follow up on pending claims.
- Assisted patients submit their claims via mobile app or email
- Answered patient inquiries regarding insurance-related matters.
- Prepared and send insurance claim forms and related documents.
- Greeted incoming visitors and customers professionally and provided friendly, knowledgeable assistance.
- Confirmed appointments, communicated with patients, and updated their records.
- Handled assignments independently with good judgement and critical thinking skills.
- Assisted internal staff with clerical and administrative needs to maximize efficiency and team productivity.
Insurance Coordinator
ZIA MEDICAL CENTER
07.2019 - 08.2021
- Handled insurance related activities
- Obtained prior authorizations from respective insurance companies for Health care services in the clinic
- Obtained prior authorization for referral patients
- Verified insurance eligibility and coverage for patients
- Pre-audit and reviewed physiotherapy claims before submission
- Provided quality customer service to members, health care providers, and other insurance companies
- Acquired specific CPT, CDT and ICD codes to ensure proper treatment and billing of all detailed procedures
- Collaborated with patient, insurance companies, and other internal staff to address wide variety of health insurance matters
- Assisted front office staff / patients with insurance related queries
Receptionist cum Insurance Coordinator
AMWAJ POLYCLINIC
12.2018 - 05.2019
- Welcomed patients arriving in the clinic
- Greeted patients, as certain purpose of visit, and directed them to appropriate staff.
- Served as the first point of contact provided direct customer service to all patients
- Answered, sorted and routed calls/emails to appropriate personnel
- Dealt with inquiries and appointment bookings by telephone, clinic's whatsapp, email, or in person
- Scheduled and confirmed patient aesthetic appointments, treatments, or medical consultations
- Provided cashier services, handled billing, collected payments, prepared daily cash report
- Filed and maintained all medical records
- Performed various clerical and administrative work
Insurance Coordinator cum Insurance Claims Processor
DRS. NICOLAS AND ASP CENTER
11.2016 - 04.2018
- Completed claims and submitted to insurance companies for payment
- Submitted Dental and Medical Claims to E-claim Link
- Made sure claims were submitted in a timely and efficient manner
- Reviewed medical and dental records for claims processing
- Prepared and verified claims for accuracy
- Reviewed insurance policies, eligibility and benefits
- Prepared paper claims made sure files are complete
- Accurately in-putted data entry of medical and dental claims information into processing system
- Provided customer service to insurance members, insurance companies, clinic branches, billing questions, complaints, follow ups
Medical Secretary cum Insurance Coordinator
PRIME MEDICAL CENTER - AL NAHDA BRANCH
09.2014 - 10.2016
- Handled insurance related activities
- Obtained prior authorizations from respective insurance companies for Health care services in the clinic
- Verified insurance eligibility and coverage for patients
- Provided quality customer service to members, health care providers, and other insurance companies
- Acquired specific CPT and ICD codes to ensure proper treatment and billing of all detailed procedures
- Assisted billing department with any denied claims when needed
- Collaborated with patient, insurance companies, and other internal staff to address wide variety of health insurance matters
- Assisted front office staff / patients with insurance related queries
- Disseminated information of insurance update
Nurse 1 - Staff Nurse
Amang Rodriguez Memorial Medical Center
01.2013 - 12.2013
- Assessed patients to make suitable nursing interventions
- Administered medication
- Prepared treatment trays, instruments and equipment
- Operated diagnostic machines
- Performed direct nursing care procedures, which include bedside nursing, hygiene, pre and postoperative care, as well as admission and discharge duties
- Observed, recorded, and reported patient's symptoms, conditions, and progress of treatment and therapy
- Prepared patients for and assisted physicians with, diagnostic and therapeutic procedures, for both normal and specialized treatment cases
- Coordinated with other sections in the hospital regarding patient care
- Performed other related duties as may be assigned
Education
Bachelor's Degree - Nursing
Divine Word College of Legazp
Legazpi, Province Of Albay, Philippines 01.2006 - 01.2010
Skills
- Knowledge of medical terminology
- Electronic claim processing
- E-claims Re-submission
- Proactive problem solver
- Collaborative team player
- Analytical thinker
- Effective time management
- Billing and invoicing
- Computer proficiency
- Multitasking Abilities
- Attention to detail
- Reception desk management
- Verbal and written communication
Certification
BLS-CPR Training - Health Care Providers, Philippine Red Cross
Awards
- Employee of the Month (Prime Star), Prime Medical Center, 12/01/15
- Employee of the Month (Prime Star), Prime Medical Center, 06/01/16
Timeline
Insurance Expert Cum Receptionist
Health and Happiness Clinic
03.2022 - 03.2025
Insurance Coordinator
ZIA MEDICAL CENTER
07.2019 - 08.2021
Receptionist cum Insurance Coordinator
AMWAJ POLYCLINIC
12.2018 - 05.2019
Insurance Coordinator cum Insurance Claims Processor
DRS. NICOLAS AND ASP CENTER
11.2016 - 04.2018
Medical Secretary cum Insurance Coordinator
PRIME MEDICAL CENTER - AL NAHDA BRANCH
09.2014 - 10.2016
Nurse 1 - Staff Nurse
Amang Rodriguez Memorial Medical Center
01.2013 - 12.2013
Bachelor's Degree - Nursing
Divine Word College of Legazp
01.2006 - 01.2010
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