I have over three years of experience in the BPO industry, specializing in the healthcare sector. My background covers a wide range of responsibilities, including DME (Durable Medical Equipment) backend operations, prescription and medical record validation, prior authorization, and insurance eligibility verification. I also managed provider communications to obtain signed documentation supporting DME orders.
As a Quality Analyst for one year, I gained in-depth knowledge of process compliance, accuracy standards, and quality assurance, ensuring that all client protocols were met efficiently. Additionally, I have served as a Healthcare Advocate under the Member Services Department, assisting both members and providers with inquiries related to eligibility, coverage, pharmacy claims, and other benefit-related concerns.
Also, I handle professional billing and medical claims, which has become my strongest area of expertise. I particularly enjoy the analytical and problem-solving aspects of claims resolution—coordinating with insurance companies, RCM departments, and clearinghouses to ensure accurate and timely payments.
