Neilsen R. Rementilla
Pasig City
Summary
To secure a challenging position in a reputable organization to expand my learnings, knowledge, and skills. Secure a responsible career opportunity to fully utilize my training and skills, while making a significant contribution to the success of the company.
Professional with strong background in medical claims analysis, adept at ensuring accurate and timely processing of healthcare claims. Skilled in data management, compliance, and problem-solving, with keen eye for detail. Focused on team collaboration and achieving results, adaptable to changing needs, and reliable in high-pressure environments. Strong analytical skills and thorough understanding of healthcare regulations and insurance policies.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Medical Claims Analyst - Denials Management
Med-Metrix
03.2023 - Current
- Analyzed medical claims to ensure compliance with regulations and accuracy of data entry.
- Collaborated with healthcare providers to resolve claim discrepancies and expedite processing.
- Verified patient insurance coverage and benefits for medical claims.
- Analyzed complex appeals, ensuring compliance with regulatory standards and organizational policies.
- Collaborated with cross-functional teams to resolve disputes effectively and efficiently.
- Analyzed medical claims for accuracy, ensuring compliance with industry regulations and internal policies.
- Identified discrepancies in claim submissions, leading to timely resolutions and improved processing time.
Collections Specialist (Sales/Finance)
AFNI Phil.
11.2019 - Current
- Managed customer accounts to ensure timely payments and reduce delinquency rates.
- Developed and implemented effective collection strategies to enhance recovery efforts.
- Managed over 50 customer calls per day.
Technical Service Rep (Tech)
Teleperformance
07.2020 - 07.2022
- Delivered exceptional customer support by troubleshooting technical issues and providing effective solutions.
- Collaborated with cross-functional teams to enhance service delivery and improve customer satisfaction ratings.
- Developed comprehensive knowledge of product features, resulting in increased first-contact resolution rates.
- Trained and mentored new hires on technical support protocols and best practices for customer interactions.
- Managed over 90 customer calls per day.
Financial Specialist (Advisory)
Concentrix
11.2016 - 11.2019
- Analyzed financial data to identify trends and provide actionable insights for management decisions.
- Developed and implemented budgeting processes, enhancing overall financial accuracy and accountability.
- Managed over 60 customer calls per day.
Education
No Degree - Information Technology
STI College
Manila01.2014
Skills
- Oriented in Microsoft office application such as MS Word, MS Excel, MS Power point
- Can communicate both English and Filipino Language
- Claims processing proficiency
- Training and mentoring
- Medical terminology
- Insurance policies
- Medical record review
- Insurance claims processing
- Thorough claims reviews
- Insurance verification
- Proficiency in Change Health Care, Epic, Meditech, etc
- Healthcare billing
- Electronic claims processing
- Claims investigation
- Analytical thinking
Accomplishments
- Achieved Subject Matter Expert through effectively helping with Process and agent questions
- Supervised team of 24 staff members.
Certification
- Certified Medical Claims Analyst, Med-Metrix - 03/06/2023 to present
PERSONAL DATA
- Birth Date: November 05, 1996
- Age: 29 years old
- Height: 5'4
- Citizenship: Filipino
- Mother’s Name: Jennifer Rementilla
- Birth Place: Pandacan Manila
- Civil Status: Single
- Weight: 59 kg
- Religion: Roman Catholic
- Father’s Name: Ronaldo Rementilla
Languages
English
Advanced (C1)
Timeline
Medical Claims Analyst - Denials Management
Med-Metrix
03.2023 - Current
Technical Service Rep (Tech)
Teleperformance
07.2020 - 07.2022
Collections Specialist (Sales/Finance)
AFNI Phil.
11.2019 - Current
Financial Specialist (Advisory)
Concentrix
11.2016 - 11.2019
No Degree - Information Technology
STI College