Experienced BPO US-Registered Nurse and Philippine Licensed Nurse – Claims Management Specialist with nearly 12 years of expertise in medical claims processing and healthcare insurance management. Highly skilled in medical billing, coding, claims analysis, and dispute resolution, ensuring accurate and efficient claims handling. Adept at navigating insurance policies, compliance regulations, and healthcare protocols to optimize claims processing and minimize errors.
A results-driven professional with a strong ability to analyze medical records, validate claims, and liaise with healthcare providers and insurance companies to ensure seamless transactions. Recognized for problem-solving, attention to detail, and excellent customer service, contributing to operational efficiency and improved turnaround times. Passionate about healthcare administration and continuously seeking opportunities for process improvement and innovation.
Key Skills:
Claims Processing
Medical Billing & Coding
Insurance Policy & Compliance
Medical Records Analysis
Dispute Resolution
Process Optimization
Client & Provider Communication
Data Accuracy & Quality Assurance
