Denial Specialist
Metro Manila, Quezon City, Philippines
"In my previous role, I was responsible for the full billing cycle—from submitting claims and tracking their status to ensure timely processing, to checking patient eligibility and benefits upfront to prevent delays. I regularly managed denials and rejections, identified root causes, and submitted timely appeals when necessary. I also stayed on top of A/R follow-ups and patient balances, which helped reduce aging claims. In addition, I frequently communicated with insurance reps and clearinghouses to resolve issues quickly, and I made sure all claim activity was properly logged and documented for accuracy and compliance."
Med-Metrix International, full_time
Mar 2022 to Jan 2026
In my role as a Denials Specialist, I analyzed denied claims to identify root causes, communicated with health insurance to appeal denials, collaborated with healthcare providers for documentation, and developed strategies to reduce denial rates. I possess proficiency in medical billing software and EHR systems, knowledge of CPT and ICD-10 coding, strong analytical skills, and effective communication abilities. My achievements include improving claim approval rates by 20%, successfully appealing 95% of denied claims, and reducing average days in accounts receivable from 45 to 30 days.
Wipro, full_time
Jun 2021 to Mar 2022
As a Provider Service Advocate, I act as a trusted partner to healthcare providers, delivering clear guidance and efficient resolution of inquiries. My role strengthens provider relationships, ensures compliance, and enhances operational efficiency. By bridging communication between providers and internal teams, I help improve patient outcomes and reinforce the organization’s reputation for reliable, responsive service.