Medical Biller | Healthcare Customer Service
Metro Manila
Hello Hiring Manager, My name is Marianne, I have over 4 years experience in healthcare industry particularly in Insurance claim, member services and provider medical billing. I have started my healthcare career supporting Aetna members by discussing and addressing their concern to their coverage, benefits , eligibility and claims. Most recently, I worked as Medical Biller Specialist where we are supporting Hackensack Meridian Health Hospital in New Jersey, I focused on claims that is denied and unpaid. I performed claims investigation , reviewing documentation , patient chart , codes and billing details to identify the root cause of the denial. If corrections are needed I update the information and gather necessary document and resubmit the claim or follow the payer's appeal process according to their guidelines. With this experience It gives me a unique advantage because I fully understand the claims process both in payer and provider's perfective.
Med-Metrix, full_time
Feb 2025 to May 2026
•Followed up on 40-50 active accounts daily resolving unpaid claim issues and supporting monthly collection target of $21,000 per representative. •Resolved denied ER, inpatient and outpatient claims through payer-specific research, documentation review and account correction. • Processed payment posting activities and updated patient accounts to maintain accurate financial records. •Conducted insurance verification and reviewed coverage information to support clean claim submission and reimbursement accuracy. •Researched billing discrepancies and resolved patient account concerns, reducing repeat inquiries through accurate account explanation. Utilized billing platforms including EPIC while documenting account activity and claim status updates.
Sagility, full_time
Sep 2021 to Jan 2025
•Resolved benefits, eligibility, claims and billing concerns for 30-40 health plan members daily while maintaining quality and compliance standards. •Provided accurate explanations of healthcare benefits and insurance policies while maintaining compliance with company guidelines. •Maintained member satisfaction through effective issue resolution and clear communication. •Coordinated with internal departments to resolve claim and coverage issues. •Maintained passing performance standards for Quality Assurance, NPS and PCS score requirements. •Processed member accounts updates and documented interactions accurately within company system.