General Virtual Assistant| Claim Examiner| Email ChatSupportGeneral Virtual Assistant| Claim Examiner| Email ChatSupport
Maria
ID Verified$800
per month
($5/hour)
Profile Description
Detail-oriented healthcare professional with over 3 years of experience in the BPO industry, specializing in healthcare claims examination, insurance verification, and eligibility verification. Experienced in reviewing claim statuses, verifying insurance benefits and coverage, resolving claim-related concerns, and ensuring accurate information in accordance with insurance policies and procedures. Equipped with strong analytical, problem-solving, communication, and customer service skills, with a...
Top Skills
Skills & Expertise
Skill Levels Explained:
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Design & Creative
E-commerce & Marketplace
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Specialized Skills
Virtual Assistance & Admin
Work Experience
Medical/Dental Billing & Claims Examiner
Global Clinical Services BPO Inc.
Aug 2023 - Jan 2026
Key Achievements:
Reviewed and evaluated medical and dental claims, records, and supporting documentation to ensure accuracy, completeness, and compliance with established guidelines. Processed and examined claims by verifying patient information, medical procedures, diagnosis codes, billing details, and eligibility before making appropriate claim determinations. Identified discrepancies, missing information, and potential billing errors, coordinating with relevant teams to resolve issues and prevent processing delays. Maintained accurate records while handling high-volume claims and sensitive healthcare information, consistently meeting quality, productivity, and turnaround-time requirements.
Email and Chat Support Specialist
Buwelo Exact Star Company
Apr 2021 - Aug 2023
Key Achievements:
Provided prompt and accurate customer support through email and live chat. Responded to customer inquiries, resolved concerns, and provided information about products and services. Assisted retailers and brands through an online wholesale marketplace by helping with their questions and concerns. Delivered friendly and reliable service while handling multiple customer inquiries in a fast-paced environment.
Healthcare Specialist / PreCertification After hours Agent
Global Clinical Services BPO Inc.
May 2021 - Aug 2021
Key Achievements:
Accurately coded medical procedures using patients’ electronic health records to ensure compliant documentation, reviewed and verified insurance claims for smooth billing, maintained detailed financial records, and conducted outbound calls to confirm patient information, enhancing data accuracy and transparency.
Quality Assurance (Inspection Sr. Leader/Trainer)
Sumi Philippines Wiring Systems Corp.
May 2013 - May 2021
Key Achievements:
Monitored product quality, identified issues, implemented corrective actions, and trained team members to maintain quality standards and improve processes.