Wynzcel Armand Ranes
Maasin, Southern Leyte,SLE
Summary
Dynamic Medical Collections Representative with a proven track record at Optum Global Advantage, enhancing revenue recovery through strategic initiatives and exceptional customer service. Skilled in HIPAA compliance and patient account management, I effectively reduced errors and improved processes, fostering teamwork and professionalism in high-pressure environments.
Experienced with medical billing systems and adept at resolving payment discrepancies efficiently. Utilizes effective communication and negotiation techniques to achieve successful collections. Knowledge of healthcare regulations and insurance processes, ensuring compliance and accuracy in all financial transactions.
Overview
7
7
years of professional experience
Work History
Medical Collections Representative
Optum Global Advantage
04.2022 - Current
- Collaborated with cross-functional teams to identify areas for improvement within the medical collections process, leading to reduced errors and increased revenue recovery.
- Implemented new strategies for recovering outstanding balances from unresponsive patients, resulting in a higher rate of successful collections efforts.
- Conducted thorough audits of patient accounts to ensure accurate billing information, reducing instances of miscommunication between providers and payers.
- Provided exceptional customer service by empathetically addressing patient concerns related to billing disputes or financial hardships.
- Streamlined medical billing procedures for increased efficiency and accuracy in the collections process.
- Maintained strict confidentiality of sensitive patient information in accordance with federal and state regulations, ensuring ethical collections practices.
Benefits Coordinator
Optum Global Advantage
04.2022 - Current
- Explained benefits to plan participants in easy to understand terms in order to educate each on available options.
- Served as primary point of contact for employee benefits inquiries, resolving issues promptly and accurately.
- Facilitated new hire orientations, providing comprehensive information on company-sponsored benefit programs.
- Coordinated open enrollment events to educate employees on benefit options and encourage informed decisionmaking.
- Ensured compliance with federal and state regulations by maintaining accurate records of all benefits-related documentation.
- Developed strong relationships with carrier representatives to address claims issues effectively while advocating for the best interests of employees.
Prior Authorization Coordinator
Optum Global Advantage
04.2022 - Current
- Improved patient satisfaction by efficiently managing prior authorization requests and ensuring timely approvals.
- Reduced errors in documentation by meticulously reviewing medical records and verifying patient information.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Collected and processed patient liability statements prior to service.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Verified eligibility and compliance with authorization requirements for service providers.
Provider Service Advocate
Wipro BPO
08.2018 - 03.2022
- Supported team members, fostering a collaborative and productive work environment.
- Improved customer satisfaction by promptly addressing inquiries and resolving issues.
- Demonstrated empathy and active listening skills when dealing with frustrated customers, diffusing tense situations effectively.
- Enhanced client retention through exceptional service delivery and proactive communication.
- Managed high call volumes while maintaining quality service standards and positive customer interactions.
- Increased first-call resolutions by employing effective problem-solving strategies tailored to each unique situation.
Customer Service Representative
Teleperformance
05.2018 - 07.2018
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
Education
Bachelor of Science - Secondary Education
Saint Joseph College
04-2018
Skills
- Assertiveness and confidence
- Critical thinking
- HIPAA compliance
- Insurance verification expertise
- Patient account management
- Teamwork orientation
- Professionalism and ethics
- Data entry proficiency
- Medical terminology proficiency
- Organization skills
- Attention to detail
- Customer service
- Documentation and recordkeeping
- Microsoft office
- Task prioritization
- Work Planning and Prioritization
- Team building
Languages
English
Timeline
Medical Collections Representative
Optum Global Advantage
04.2022 - Current
Benefits Coordinator
Optum Global Advantage
04.2022 - Current
Prior Authorization Coordinator
Optum Global Advantage
04.2022 - Current
Provider Service Advocate
Wipro BPO
08.2018 - 03.2022
Customer Service Representative
Teleperformance
05.2018 - 07.2018
Bachelor of Science - Secondary Education
Saint Joseph College
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