USRN | Insurance Verification Specialist|Medical Records Review

Overview

Looking for full-time work (8 hours/day)

at $9.10/hour ($1,760.00/month)

Bachelor in Science in Nursing

Last Active

July 9th, 2026 (6 days ago)

Member Since

December 18th, 2016

Profile Description

      A Registered nurse for 15 years, with 6 year job experience in  Business Process Outsourcing (Healthcare) plus a wonderful 4 years experience as a Healthcare Virtual Assistant. I am also certified in HIPAA Compliance and attended an OASIS training before becoming a VA. I have advanced knowledge of the US healthcare system and different health insurance plans. A highly organized, fast learner, attentive to details and ensures 100% quality of work.
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       Kathryn is an experienced and hard-working registered nurse, with a decade of experience both in the hospital & office set-up. She has advanced knowledge of the US healthcare system which includes worker's compensation benefits and home health. Kathryn's colleagues at previous works describe her as enthusiastic, self-motivated, hardworking, flexible, patient, and honest. She always accomplishes any task assigned efficiently &promptly. She is professionally motivated by the desire to do tasks to the best of her abilities. Now venturing into the exciting world of virtual healthcare, Kathryn is more than ready to take on any challenge using her knowledge and skills.

TOOLS:
*Insurance verification: Pverify | Availity | Inovalon
*Zoom | Microsoft Teams*Microsoft Office
*EMR/EHR: Practicefusion | Athena | Next-Gen | E-claims/E-clinicals
*Google Spreadsheet | Gmail | Google Workspace
*Adobe Acrobat
*OASIS (Outcome and Assessment Information Set - Kinnser/ Axxesscare) 
*Slack/Notion/Click-up/Airtable 
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WORK EXPERIENCE:                                                                                                       
  1.  ---------- | Medical Virtual Assistant | Home Health Care Intake/ Data Entry & Medical Records Review | Insurance Verification Specialist
*Review Home Health referral PDFs Medical Records & enter the specific orders (Skilled Nursing, Wound Care, Medication Management, Physical Therapy, Occupational Therapy, Home Health Aide Services, etc.) into the Intake form.
*OASIS trained for Medicare home health claims.
*Identifying the diagnosis codes (ICD-10) which is/are related to the Home Health plan of care.
*Verifying the patients' insurance eligibility using an online tool (Pverify & Availity).  - (Medicare, Medicaid, UHC, Humana, Molina, BCBS, Aetna, Cigna, Devoted, Wellpoint/Amerigroup, Wellcare, Tricare, etc.)
*Send referral packages and coordinate to Home Health agencies based in Texas, USA.     

 2. ---------- Department of Health Philippines | Public Health Associate 
* Collection and validation of health-related data.
*Submit health reports/data/information to DOH Regional Office and Central Office

3.  ---------- Cognizant Technology Solutions | Data Analyst Nurse (Utilization Review/ Claims) 
*Reviewing the medical records attached to the claims such as doctor’s notes, nurse’s notes, Physical therapy notes &laboratory results, and diagnoses for proper reimbursement of medical services.
*Recommends if medical services (worker's compensation claims) are medically necessary. 

4.  ---------- Santissima Trinidad Hospital of Daet | Staff Nurse 
*Identifies patient care requirements by thorough assessment; analyzes situations to anticipate pathophysiological problems &detect status changes. Documents patient care services by charting & maintaining the confidentiality of patients’ records. 

---------- American International Group |  ---------- American International Group 
*Medical Coding Review- ensuring that the descriptions of medical diagnoses & procedures are into the correct universal medical code numbers (ICD-9/ ICD-10/ HCPCS/ CPT).
*Associate the diagnosis codes with the appropriate procedure codes and sequence the codes in such a way as to ensure proper reimbursement.