Emmanuel

MEDICAL - Biller, Insurance Verification, Authorization, Sch

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Overview

Looking for part-time work (6 hours/day)

at $6.66/hour ($960.00/month)

Associates degree

Last Active

November 18th, 2025 (222 days ago)

Member Since

June 9th, 2025

Profile Description

WORK EXPERIENCE

1. Concentrix - Amazon Seller Support since August 2016 (8 months stay)

-Served as a Seller Support Representative, providing dedicated assistance to third-party sellers.
-Managed and resolved inquiries related to product listings, ensuring accuracy and compliance with Amazon’s policiesSupported sellers with Fulfillment by Amazon (FBA) processes, including inventory management and shipment creation.
-Assisted with shipping-related issues, troubleshooting delays, and coordinating logistics to enhance seller satisfaction.
-Collaborated cross-functionally with internal teams to address complex seller concerns and improve overall service quality.
-Maintained up-to-date knowledge of Amazon’s evolving policies and systems to provide timely and accurate guidance.

2. Convergys - March 2017 as a Customer Service Representative supporting Cigna Insurance (1 year and 3 months)

-Handled complex medical claims inquiries, authorizations, insurance verifications, benefits, and eligibility questions with accuracy and professionalism.
-Delivered exceptional customer service to policyholders, healthcare providers, and internal teams, ensuring clear communication and issue resolution.
-Consistently recognized as a top performer for 8 consecutive months due to high-quality service, efficiency, and adherence to performance metrics.
-Promoted to Senior Customer Service Representative within 7 months, reflecting leadership capabilities and advanced knowledge of insurance processesProvided mentorship and guidance to new hires and tea ---------- mbers, contributing to overall team performance and morale.
-Utilized strong problem-solving skills to resolve escalated cases and complex issues, improving customer satisfaction and retention.
-Maintained up-to-date knowledge of Cigna’s policies, procedures, and healthcare regulations to ensure compliance and accurate support.

3. Hinduja Global Solutions - June 2018 as a Team Leader (4 years)

-Started as a Healthcare Representative for 11 months, providing support for laboratory services.
-Promoted to Team Leader, overseeing daily operations and team performance.
-Managed three Lines of Business (LOBs) including inbound calls, outbound calls, and chat support for Laboratory Corporation of America (LabCorp).
-Assisted with authorizations, insurance verifications, claims processing, and payment inquiriesCoordinated workflow and ensured compliance with company policies and healthcare regulations.
-Led, coached, and motivated a team to achieve service level targets and improve customer satisfaction.
-Collaborated with cross-functional teams to resolve complex issues and streamline processes

4. Freelancing since July 2022 - onwards, providing specialized services in medical billing and insurance management.

-Employed at Premier Medical Services for 3 years as Billing Manager.Oversaw insurance verification, medical billing, coding, payment processing, and accounts receivable.
-Managed and supervised a team to ensure accurate and timely billing operations.
-Specialized as a Workers’ Compensation Billing Specialist, processing claims for injured workers with precision and compliance.
-Coordinated with insurance companies, healthcare providers, and patients to resolve billing discrepancies and expedite payments.
-Ensured adherence to regulatory requirements and company policies to maintain billing accuracy and reduce claim denials.

Certification & Skills

-Proficient in using Electronic Medical Records (EMR) systems including DaisyBill, Elation, Althea, Paragon, and Facets.
-Certified in HIPAA compliance, ensuring patient privacy and data security in all healthcare operations.
-Words per minute : 98.
-Expertise in Microsoft Offices.
-Fluent in English language.
-C2 in IELTS

Working System and Tools

-I have a Macbook M3 and windows laptop i5.
-Noise cancelling headset.
-Working station setup (quiet environment).
-High definition camera with reliable and fast internet speed up to 250 mbps.

Top Skills

Office and Administration » Calendar Management » Scheduling

Experience: 5 - 10 years

Appointment scheduling skills include coordinating patient appointments efficiently, verifying insurance and referral requirements, managing provider calendars, and minimizing scheduling conflicts. Proficiency in using scheduling software and EMR systems, along with strong communication, multitasking, and customer service skills, is essential. Attention to detail, professionalism, and HIPAA compliance are also critical in handling sensitive patient information.

Professional Services » Medical Services » Medical Billing

Experience: 5 - 10 years

Commercial insurance medical billing skills include CPT, ICD-10, and HCPCS coding, verifying insurance eligibility and benefits, submitting and tracking claims, managing denials and appeals, posting payments, handling charge entry, and coordinating benefits. Knowledge of PPO, HMO, EPO, and POS plans, along with experience working with major payers like Aetna, Blue Cross Blue Shield, and UnitedHealthcare, is essential. Proficiency in EMR/EHR systems such as Epic or Kareo, using clearinghouse and payer portals, and ensuring HIPAA compliance are also important. Strong communication, attention to detail, organization, and problem-solving abilities complete the skill set.

Customer Support » Insurance » Prior Authorization

Experience: 5 - 10 years

Prior authorization skills include verifying insurance coverage and policy requirements, determining medical necessity based on payer guidelines, submitting authorization requests accurately and timely, following up with insurance companies for approval status, and documenting all communications. Proficiency in using EMR systems, payer portals, and maintaining HIPAA compliance is essential. Strong attention to detail, communication, and the ability to navigate complex insurance policies are also key.

Other Skills

E-Commerce » Amazon » Seller Page Management

Experience: 6 months - 1 year

Skills include assisting sellers with product listings, updating titles, descriptions, and images, troubleshooting listing errors, and ensuring compliance with Amazon’s guidelines. Experience with shipping coordination, tracking issues, FBA/FBM processes, and resolving delivery problems is essential. Proficiency in using Amazon Seller Central, strong problem-solving skills, and knowledge of marketplace policies are critical. Excellent communication, attention to detail, and the ability to handle high-volume inquiries efficiently are also important for success in this role.

Customer Support » Chat Support

Experience: 6 months - 1 year

I am proficient in using chat support platforms such as Zendesk and Freshdesk to efficiently manage patient inquiries related to billing and insurance. I have experience navigating electronic health record (EHR) systems like Epic and Cerner, which allows me to access and verify billing information accurately. Familiarity with customer relationship management (CRM) tools helps me track patient accounts and resolve payment issues effectively. I am skilled in using ticketing systems for tracking and escalating complex billing concerns. Additionally, I understand secure messaging protocols and encryption tools to ensure patient financial data remains confidential. I am comfortable with appointment scheduling software and have experience supporting automated billing inquiries through chatbot systems, helping to streamline patient billing support.

Professional Services » Medical Services » Credentialing

Experience: 1 - 2 years

Medical credentialing skills include verifying provider qualifications, licenses, board certifications, education, and work history. Experience with payer enrollment, CAQH management, NPI registration, and Medicare/Medicaid credentialing is essential. Proficiency in using credentialing software and portals, maintaining accurate records, and ensuring compliance with state, federal, and accreditation standards is critical. Strong attention to detail, organization, time management, and communication skills are also key to managing deadlines and resolving discrepancies.

Basic Information

Age: 28

Gender: Male

Website: Sign Up with Pro Account to View

Address: Marikina City, Metro Manila

Tests Taken: IQ
Score: 133: DISC
Dominance: 38%
Influence: 14%
Steadiness: 25%
Compliance: 23%: English
C2(Advanced/Mastery)

Government ID: Sign Up with Pro Account to View

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