Maria Sylvia Empesto
Caloocan City, Metro Manila
Summary
Quality-focused professional prepared for role. Known for delivering impactful results through keen analytical skills, strong attention to detail, and deep understanding of quality control processes. Proven ability to collaborate effectively within teams and adapt to changing requirements. Skilled in identifying and resolving issues, ensuring compliance, and driving continuous improvement initiatives.
Overview
6
6
years of professional experience
Work History
Quality Analyst
Med-Metrix International Ph-II
09.2023 - Current
- Analyzed quality and performance data to support operational decision-making.
- Created and revised procedures, checklists and job aids to reduce errors.
- Developed and maintained quality assurance procedure documentation.
- Provided regular updates to team leadership on quality metrics by communicating consistency problems or production deficiencies.
Medical Claims Analyst
Med-Metrix International PH-I
09.2022 - 09.2023
- Improved customer satisfaction by resolving complex medical claims in a timely and professional manner.
- Regularly attended Team meetings to stay informed about emerging trends and best practices in medical claims analysis.
- Conducted comprehensive audits to identify inconsistencies and irregularities in medical claims data.
- Follow-up claims for status, denials, payments and/or appeal.
Health Admin New Associates
Accenture, Inc.
08.2020 - 08.2022
- Deliver operational improvements to medical benefits set-up, billing, provider enrollment and claims processes to improve overall service
- Processing and analyzing medical claims thoroughly to approve and/or deny.
Contract Analyst
Eximius BPO Services, Inc.
05.2019 - 06.2020
- Reviewing Lease Contracts for accuracy and compute all financial information.
- Abstract the contract according to the process required by the client.
Education
Bachelor of Science - Mathematics
Polytechnic University of The Philippines
Manila05-2019
Skills
- Quality process and improvement
- Data analysis
- Claims processing proficiency
- HIPAA compliance
- Training and mentoring
- Medical terminology
- Insurance policies
- Customer service
- Insurance claims processing
- Insurance verification
- Critical Decision-making
- Knowledgeable in EPIC, MEDITECH, Payer Portals & Change Healthcare
- Healthcare billing
- Electronic health records (EHR)
- Electronic claims processing
- Teamwork and collaboration
- Time management
- Attention to detail
Timeline
Quality Analyst
Med-Metrix International Ph-II
09.2023 - Current
Medical Claims Analyst
Med-Metrix International PH-I
09.2022 - 09.2023
Health Admin New Associates
Accenture, Inc.
08.2020 - 08.2022
Contract Analyst
Eximius BPO Services, Inc.
05.2019 - 06.2020
Bachelor of Science - Mathematics
Polytechnic University of The Philippines
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