Rayan Ondoy
Senior Healthcare Operations & RCM Specialist
Taguig,00
Summary
Senior healthcare operations specialist with 15+ years of experience in U.S. DMEPOS and PAP therapy services, complemented by deep expertise in Revenue Cycle Management (RCM). Demonstrated success in enhancing patient compliance, minimizing claim denials, and driving operational efficiency. Proficient in insurance verification, prior authorizations, EMR systems, and HIPAA compliance, with a consistent focus on accuracy, reimbursement optimization, and patient-centered care.
Overview
15
15
years of professional experience
Work History
PAP Therapy Resupply Patient Support Level 3
AdaptHealth
08.2019 - 04.2026
- Reduced insurance claim denials by accurately verifying benefits with Medicare, Medicaid, and commercial payers, ensuring faster patient eligibility and therapy access.
- Boosted PAP therapy adherence by 20% through proactive resupply scheduling, equipment setup coordination, and patient education on CPAP/BIPAP usage.
- Improved EMR documentation accuracy by conducting thorough data verification and coordinating intake across multiple patient records, strengthening compliance and care coordination.
- Maintained audit readiness and HIPAA compliance with zero reported breaches by preparing Medicare documentation, ABNs, and equipment instruction forms, safeguarding patient confidentiality.
- Enhanced patient communication by managing inbound/outbound calls, follow‑ups, and troubleshooting, improving satisfaction and continuity of care.
- Streamlined supply chain coordination by monitoring resupply schedules and proactively resolving delays, ensuring uninterrupted patient therapy.
- Handled high‑volume communications by managing 80+ daily calls, emails, and faxes from patients and providers, maintaining responsiveness and efficiency.
Team Lead
Classic SleepCare
- Directed daily PAP operations, overseeing patient intake, medical record review, and insurance compliance for 1000+ patients weekly, ensuring seamless workflow execution.
- Supervised and coached a team of 10+ staff, improving accuracy by 15%, reducing turnaround times by 20%, and consistently meeting call metric targets.
- Reduced insurance denials by 25% by strengthening verification workflows and implementing compliance checks, improving reimbursement outcomes.
- Developed Excel dashboards to track productivity and generate operational reports, increasing visibility of KPIs and reducing reporting time by 30%.
- Facilitated onboarding and training for new hires, authored SOPs, and enforced HIPAA standards, achieving 100% compliance in internal audits.
- Promoted a positive work environment by fostering teamwork, open communication, and employee recognition initiatives, reducing staff turnover by 10%.
- Enhanced team performance through regular coaching, feedback, and skill development opportunities, resulting in a 20% improvement in overall productivity.
- Established clear performance metrics to track progress toward targets, increasing accountability and transparency across the team.
- Provided hands‑on coaching to team members, equipping them with techniques that improved task completion accuracy by 12%.
Medigap Policy Sales Associate
IBEX Global Solution
- Achieved policy sales targets by verifying patient data and insurance eligibility.
- Improved retention by educating patients on coverage limitations and financial responsibility.
- Developed new client relationships by actively engaging with potential customers and highlighting the benefits of our product offerings.
- Solved customer challenges by offering relevant products and services.
Education
Associate - Accountancy
ACLC
Some College (No Degree) - HRM
Pinamalayan Maritime Foundation
Skills
- Patient intake and eligibility verification
- Insurance verification and compliance workflows
- Prior authorization request submission and tracking
- Knowledge of payer rules and medical necessity criteria
- Appeals management and denial resolution
- Patient communication and reassurance scripting
- Documentation accuracy and medical record review
- Workflow optimization using Brightree, Waystar, Availity, Salesforce
- Coordination of CPAP therapy and DME resupply processes
- In-depth understanding of CMS and Medicare DME/HME policies, documentation, and coverage criteria
- HIPAA compliance and data security
- EMR/EHR systems proficiency
- Claims processing and revenue cycle management
- Cross-functional collaboration with providers and payers
- Performance metrics tracking and process auditing
TOOLS
- Brightree • Salesforce • Waystar • Availity • Epic • Cerner • Allscripts • Kareo • NextGen Healthcare • Meditech • Navinet • Change Healthcare • McKesson • Microsoft Excel • Windows OS & Applications • Patient Care Live • Genesys • ResMed SNAP
Certification
- HIPAA Certification
VGM Courses Certifications (50+)
- Service Excellence Award (multiple)
- Positive Spark Award (multiple)
- Most Valuable Person
Timeline
PAP Therapy Resupply Patient Support Level 3
AdaptHealth
08.2019 - 04.2026
Team Lead
Classic SleepCare
Medigap Policy Sales Associate
IBEX Global Solution
Associate - Accountancy
ACLC
Some College (No Degree) - HRM
Pinamalayan Maritime Foundation