Madelyne Leila Gauna
Bay, Province Of Laguna,LAG
Summary
Dynamic Medical Billing Assistant with proven expertise in HIPAA compliance and insurance verification as a long-term virtual freelancer. Enhanced team efficiency through meticulous data entry and auditing, while delivering exceptional customer service. Recognized for reducing billing discrepancies and optimizing workflow, demonstrating strong organizational skills and critical thinking in a fast-paced environment.
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Professional with high standards, ready to excel in virtual support roles. Strong background in administrative tasks, project management, and client communication. Known for teamwork, adaptability, and delivering results. Skilled in scheduling, email management, and data entry. Recognized for being dependable, adaptable, and consistently focused on achieving measurable outcomes.
Overview
6
6
years of professional experience
Work History
Medical Billing Assistant
Freelancer
11.2023 - Current
- Proficiently utilized medical billing tools, including EMR/EHR systems, Office Ally, Prompt, Tebra, and payer portals such as Availity, NaviNet, Novitasphere, and UHC, to ensure accurate and timely claim submissions.
- Handled various US-based insurance providers, both private (e.g., Aetna, Cigna, UnitedHealthcare, Blue Cross Blue Shield, Humana, Anthem, Kaiser Permanente, Molina Healthcare, etc.) and public (Medicare and Medicaid), ensuring proper claim handling and processing.
- Contributed to a well-organized office environment through meticulous record-keeping and file management practices.
- Increased team efficiency by providing cross-functional support in medical billing, insurance verification, and data entry tasks.
- Safeguarded patient privacy, adhering to strict HIPAA regulations during all aspects of the billing process.
- Reduced billing discrepancies by diligently reviewing medical coding by working hand-in-hand with coders, ensuring accuracy in data entry.
- Collaborated with healthcare providers to obtain necessary documentation for accurate claim submissions.
- Optimized workflow efficiency within the department using strong organizational skills when prioritizing tasks under tight deadlines.
- Posted payments and collections on a regular basis.
- Verified insurance of patients to determine eligibility.
- Filed and updated patient information and records.
- Delivered timely and accurate charge submissions.
- Audited and corrected billing and posting documents for accuracy.
- Regularly responded to customers' and colleagues' concerns and questions and properly documented each account.
Licensed Insurance Agent
Pru Life UK
08.2021 - Current
- Calculated quotes and educated potential clients on insurance options.
- Recommended type and amount of coverage based on analysis of customers' circumstances using persuasive sales techniques.
- Leveraged knowledge of company insurance products and services to advise customers on appropriate choices.
- Improved client satisfaction by providing tailored insurance solutions and exceptional customer service.
Business Care Representative
Acquire BPO
11.2022 - 10.2023
- Contributed to company growth by identifying new business opportunities through proactive client outreach and diligent market analysis.
- Exceeded performance targets consistently by prioritizing workload effectively and focusing on high-impact tasks first.
- Improved efficiency within the team by identifying opportunities for process optimization and implementing necessary changes promptly.
- Negotiated favorable contract terms with vendors, saving the company resources while maintaining high-quality services.
- Used client-specific tools to research inquiries, document customer interactions and issue resolutions.
Customer Service Representative
VXI Global Solutions LLC
08.2022 - 10.2022
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
Education
Bachelor of Arts - Political Economy
Polytechnic University of The Philippines
Santa Mesa, Metro Manila, Philippines 08.2021 - 08.2022
High School Diploma -
STI College
Calamba, Province Of Laguna, Philippines 06.2017 - 04.2019
High School Diploma -
Laguna Science National High School
Bay, Province Of Laguna, Philippines 06.2013 - 04.2017
Skills
HIPAA Compliance
Healthcare Revenue Cycle Management (RCM)
Accounts Receivable (AR)
Medical Billing Technology
Electronic Health Record Software Utilization
Database Systems and CRMs
Bookkeeping
Data Entry and Analysis
Patient Account Analysis
Billing and Auditing Procedures
Sales and Collections Management
Insurance Application, Verification, and Claims Processing
Financial Planning
Life Insurance Policy Review (Traditional and VUL)
Customer Service & Care
Critical Thinking
Teamwork and Collaboration
Effective Time Management
Multitasking and Organization
Email and Engagement Prompts
Graphic Design
Social Media Management
SEO and AI Optimization
Timeline
Medical Billing Assistant
Freelancer
11.2023 - Current
Business Care Representative
Acquire BPO
11.2022 - 10.2023
Customer Service Representative
VXI Global Solutions LLC
08.2022 - 10.2022
Licensed Insurance Agent
Pru Life UK
08.2021 - Current
Bachelor of Arts - Political Economy
Polytechnic University of The Philippines
08.2021 - 08.2022
High School Diploma -
STI College
06.2017 - 04.2019
High School Diploma -
Laguna Science National High School
06.2013 - 04.2017
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