MILAREY PACETE
MEDICAL VIRTUAL ASSISTANT, PRIOR AUTHORIZATION, AGING REPORTS SPECIALIST
COTABATO CITY
Summary
Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
4
4
years of professional experience
Work History
MEDICAL BILLER AND AGING REPORT SPECIALIST
Retina Partners Midwest Eye Institute Indiana
09.2023 - 01.2025
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Verified insurance of patients to determine eligibility.
- Improved patient satisfaction levels with clear explanations of their financial responsibilities and available payment options.
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Reduced claim denials by meticulously reviewing patient insurance information and coding practices.
- Delivered timely and accurate charge submissions.
- Analyzed complex Explanation of Benefits forms to verify correct billing of insurance carriers.
- Used data entry skills to accurately document and input statements.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
Prior Authorization Specialist
Hello Rache
08.2022 - 08.2023
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Enhanced efficiency in processing prior authorization requests by streamlining documentation procedures.
- Contributed to a high level of customer service by quickly addressing questions or concerns from patients regarding their coverage or denials.
- Collaborated with physicians to obtain necessary clinical information for prior authorization submissions.
- Conducted thorough reviews of medical documentation to ensure compliance with payer policies and patient care standards.
- Implemented tracking system for prior authorization requests to monitor progress and identify bottlenecks.
- Advocated for patients by negotiating with insurance providers to cover necessary treatments not initially authorized.
Marketing and Sales Training Supervisor
Tupperware Philippines
07.2021 - 05.2022
- Managed a team of trainers to ensure consistent delivery of high-quality training sessions across all departments.
- Mentored new hires during their onboarding process, accelerating their integration into the company culture and work environment.
- Established a culture of continuous learning by implementing regular feedback loops and performance evaluations.
- Collaborated with company leaders and department managers to determine training needs.
Education
Associate of Science - Midwifery
Notre Dame Hospital And School Midwifery
Cotabato City 05.2001 -
Bachelor of Science - Major in Management
Notre Dame of Tacurong College
Tacurong, Province Of Sultan Kudarat, Philippines 05.2001 -
Skills
Claims review
Billing and collection procedures
Clerical support
Multitasking and organization
HIPAA compliance certification
Teamwork and collaboration
CPT knowledge
ICD-10 proficiency
Customer service
Data entry
Claims processing
Verbal and written communication
Work prioritization
Timeline
MEDICAL BILLER AND AGING REPORT SPECIALIST
Retina Partners Midwest Eye Institute Indiana
09.2023 - 01.2025
Prior Authorization Specialist
Hello Rache
08.2022 - 08.2023
Marketing and Sales Training Supervisor
Tupperware Philippines
07.2021 - 05.2022
Associate of Science - Midwifery
Notre Dame Hospital And School Midwifery
05.2001 -
Bachelor of Science - Major in Management
Notre Dame of Tacurong College
05.2001 -