Vanessa Grace Ela
Virtual Assistant/Freelancer
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
9
9
years of professional experience
Work History
Medical Biller
Amcarepro Home Health
05.2022 - Current
- 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.
- Filed and updated patient information and medical records.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Posted payments and collections on regular basis.
- Implemented quality control measures to identify potential errors before submitting claims, reducing rejections significantly.
- Delivered timely and accurate charge submissions.
- Collaborated with healthcare providers, ensuring accurate documentation for seamless billing operations.
- Collected payments and applied to patient accounts.
- Resolved discrepancies in accounts receivable reports, contributing to improved cash flow management.
- Established strong relationships with insurance representatives, facilitating prompt resolution of billing issues.
- Trained new team members in medical billing software, increasing efficiency within the department.
- Negotiated favorable payment terms with third-party payers, improving overall revenue collection rates.
- Reviewed outstanding balances owed by patients; initiated collection actions if necessary resulting in improved account recovery efforts.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
- Enhanced revenue collections for the medical practice with diligent follow-ups on unpaid claims.
- Assisted patients in understanding insurance benefits, leading to a positive experience during their visit.
- Utilized various software programs to process customer payments.
- Used data entry skills to accurately document and input statements.
- Audited and corrected billing and posting documents for accuracy.
- Handled account payments and provided information regarding outstanding balances.
- Monitored outstanding invoices and performed collections duties.
- Responded to customer concerns and questions on daily basis.
- Maintained accurate records of customer payments.
- Generated accounts payable reports for management review to aid in financial and business decision making.
- Reconciled accounts receivable to general ledger.
- Generated monthly billing and posting reports for management review.
Revenue Claims Management Specialist HH
Cliniqon CPO Inc.
09.2022 - 04.2024
- Assisted in developing policies and procedures related to the claims management process, promoting consistency across the organization.
- Collaborated with legal teams to successfully negotiate disputed settlements, protecting company interests.
- Implemented cost-saving measures by identifying inefficiencies in the claims management process.
- Created detailed reports to analyze trends in claim submissions, leading to proactive strategies for minimizing risk exposure.
- Reduced fraudulent claims by conducting thorough investigations and implementing strict verification procedures.
- Reviewed medical records and other documentation to accurately assess injury or property damage claims.
- Enhanced customer satisfaction with prompt and accurate claims processing.
- Established strong relationships with policyholders through clear communication and empathetic handling of sensitive situations.
- Managed a large caseload of diverse claims, ensuring accurate evaluations and timely resolutions.
- Developed training materials for new staff members, resulting in faster onboarding and improved productivity.
- Improved claim resolution times by streamlining processes and implementing efficient workflows.
- Conducted audits of closed claim files to ensure compliance with established guidelines, contributing to company-wide adherence to high standards.
- Followed up with customers on unresolved issues.
- Increased workflow efficiency by automating routine tasks and optimizing resource allocation within the team.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Researched claims and incident information to deliver solutions and resolve problems.
- Evaluated and settled complex insurance claims in strict timeframes.
- Read over insurance policies to ascertain levels of coverage and determine whether claims would receive approvals or denials.
- Examined claims forms and other records to determine insurance coverage.
- Maintained claims data in systems.
- Collected information from customers to complete claims and legal files.
- Delivered exceptional customer service to policyholders by communicating important information and patiently listening to issues.
- Reviewed police reports, medical treatment records, and physical property damage to determine extent of liability.
- Analyzed information gathered by investigation and reported findings and recommendations.
- Followed up with insured individuals regarding premium and deductibles payments.
- Clarified coverage of losses to policyholders and provided assistance in itemizing damages and finding alternative living arrangements.
- Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
- Organized, planned and documented materials for claims.
- Payment posting.
- Eligibility and Intake support.
Diagnostic Tracking Review Associate
Amerihealth Group LLC
01.2021 - 03.2022
- Increased customer satisfaction by resolving complex issues and providing exceptional service at all times.
- Prioritized tasks to meet tight deadlines, pitching in to assist others with project duties.
- Greeted customers and offered assistance for increased customer satisfaction.
- Back-office support for claims tracking.
- Updating diagnostic records and results.
- Uploading and verifying diagnostic results.
- Diagnostic pre-authorization checking and requesting to insurances.
- Scheduling patients for diagnostic and follow-up visit.
- Managed customer relations through communication and helpful interactions.
- Provided product price information to customers.
Claims Specialist
Northeast Solutions Inc.
09.2019 - 12.2020
- Understood requirements for disputes, gathered evidence to support claims and prepared customer cases to handle appeals.
- Managed a high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Improved claim processing efficiency by streamlining workflows and implementing time-saving strategies.
- Conducted full claim investigations and reported updates and legal actions.
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Responded to inquiries by answering questions, providing information and directing customers to appropriate resources.
- Followed up with customers on unresolved issues.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Checked documentation for accuracy and validity on updated systems.
- Calculated adjustments, premiums and refunds.
- Posted payments to accounts and maintained records.
Area Sales Coordinator
Progear International Group Inc.
05.2016 - 04.2018
- Field stocks audit.
- Korean Schools stocks audit.
- Meeting with the clients for stocks distributions.
- Training new agents for product familiarizations.
Sales Coordinator and Room Reservations
Apo View Hotel Managed By Eurotel
06.2015 - 09.2016
- Maintained accurate records of all sales activities, including contracts, proposals, quotes, follow-ups, and customer communications.
- Handled customer inquiries by staying up-to-date on market and industry trends and finding unique solutions to issues.
- Reviewed sales performance data regularly to identify areas for improvement and implement corrective actions when needed.
- Worked closely with the sales team to prioritize tasks, set goals, and allocate resources efficiently; resulting in increased productivity and revenue.
- Maintained long-term relationships with high net-worth clients.
- Kept detailed records of sales and customer information in CRM software, updating database regularly to maintain top-notch service.
- Collaborated with marketing team to develop targeted promotional materials and campaigns.
- Employed closing sales techniques, upselling and customer loyalty incentives to boost sales.
- Increased sales revenue by establishing strong relationships with clients and identifying new business opportunities.
- Managed customer accounts to secure customer satisfaction and repeat business.
- Negotiated contracts with clients and developed relationships with key personnel.
- Trained and mentored new sales representatives.
- Promoted business' development by building and maintaining relationships with new clients.
- Taking room reservations and event inquiries.
Customer Service Representative
Startek International LTD
09.2015 - 04.2016
- Handled customer inquiries and suggestions courteously and professionally.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Answered constant flow of customer calls with minimal wait times.
- Responded to customer requests for products, services, and company information.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Participated in team meetings and training sessions to stay informed about product updates and changes.
- Provided primary customer support to internal and external customers.
- Assisted customers in navigating company website and placing online orders, improving overall user experience.
- Utilized customer service software to manage interactions and track customer satisfaction.
- Analyzed customer service trends to discover areas of opportunity and provide feedback to management.
- Developed customer service policies and procedures to meet and exceed industry service standards.
Education
Completed SY 2012-2013 - Aviation Electronics
Asian International School of Aeronautics And Tech
Davao City, Province Of Davao Del Sur, Philippines 05.2001 -
Vocational - Front Office Services
St. Albans College of Technology
Davao City, Philippines 05.2001 -
Skills
Medical Transcription
Claims review
Billing and Collection Procedures
Clerical Support
Multitasking and Organization
Records Management/Denial Management
CPT Knowledge
ICD-10 Proficiency
Payment posting
Operations Support
[Software] use
Microsoft Office
Greeting guests
Teamwork orientation
Guest Reception
Reservations
Problem-Solving
Hospitality services
Data Entry
Multitasking
Customer Service Management
Excellent Communication
Timeline
Revenue Claims Management Specialist HH
Cliniqon CPO Inc.
09.2022 - 04.2024
Medical Biller
Amcarepro Home Health
05.2022 - Current
Diagnostic Tracking Review Associate
Amerihealth Group LLC
01.2021 - 03.2022
Claims Specialist
Northeast Solutions Inc.
09.2019 - 12.2020
Area Sales Coordinator
Progear International Group Inc.
05.2016 - 04.2018
Customer Service Representative
Startek International LTD
09.2015 - 04.2016
Sales Coordinator and Room Reservations
Apo View Hotel Managed By Eurotel
06.2015 - 09.2016
Completed SY 2012-2013 - Aviation Electronics
Asian International School of Aeronautics And Tech
05.2001 -
Vocational - Front Office Services
St. Albans College of Technology
05.2001 -
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