Medical Billing Specialist | Surgery Coordination Support
Laguna, Cabuyao, PH
I'm a medical billing specialist with 4+ years of dedicated healthcare experience, plus 9+ years overall in BPO and customer service. I started on the payer side at Carelon Global Solutions, handling provider claims, eligibility verification, and prior authorization support under strict SLA targets. Since October 2024, I've worked as a Freelance Medical Billing Specialist for Meadows Eye Physicians & Surgeons, a U.S. ophthalmology practice, where I verify insurance coverage ahead of scheduled procedures, calculate patient out-of-pocket responsibility (deductibles, coinsurance, copays), and handle claims submission, corrected claims, appeals, and AR follow-up. I'm HIPAA-trained, comfortable working independently in a remote setup, and experienced with tools like CareRails, Availity, and Waystar. I'm looking for a long-term, stable client relationship where I can bring reliable, detail-focused billing support to a growing practice.
MEADOWS EYE PHYSICIAN & SURGEONS, freelance
Oct 2025 to Jul 2026
I support U.S. medical practices with the administrative and coordination side of patient care. I manage a 2-week advance surgery tracker, verifying insurance coverage and calculating estimated patient out-of-pocket costs ahead of scheduled procedures. I coordinate closely with surgery and prior authorization teams to keep everything on track, communicate directly with patients regarding billing and cost questions, and maintain accurate records using EHR/practice management systems like CareRails.
CARELON GLOBAL SOLUTIONS, full_time
Sep 2021 to May 2026
Handled provider calls and live chat inquiries related to claim status, member benefits, eligibility, and prior authorization for a healthcare payer account. Audited incoming claims and flagged incomplete ones for reprocessing or secondary review. Explained complex claim denials clearly to network providers to support faster resolution. Managed Service Request (SR) inventory end-to-end — from intake and routing to tracking and closure. Maintained high data accuracy while consistently meeting strict SLA targets in a high-volume, fast-paced environment.