RN

Hi, I'm Shean, a PH Registered Nurse and Medical Virtual Assistant with over 10 years of combined experience in medical billing, insurance verification, healthcare customer service, claims management, and prior authorization processing.

Currently serving as a Medical Biller for a U.S.-based Durable Medical Equipment (DME) provider. I specialize in insurance verification, sales order validation, accurate claim submission, denial management, payment posting, and claim status tracking. I am committed to maximizing reimbursement accuracy, and reducing claims denials.

Previously, I spent 6 years supporting a major U.S. health insurance account, developing expertise in benefits and eligibility verification, medical claims processing, prior authorization requests, and provider support. My experience includes both phone-based and offline authorization processing, collaborating closely with healthcare providers to ensure timely and accurate approvals.

In addition to frontline healthcare support, I served as an Inventory Specialist for Authorizations, where I coordinated work distribution, monitored aging cases, and tracked team productivity to ensure service level compliance. I also held a Team Leader role, successfully managing and mentoring a team of 10–20 healthcare associates while maintaining operational efficiency and quality standards.

Core Competencies
Insurance Verification & Eligibility
Prior Authorizations
Claims Submission & Payment Posting
Denial Management & Appeals Follow-Up
Durable Medical Equipment (DME) Billing
Medicare Advantage & Commercial Insurance Plans
Team Leadership & Performance Monitoring

Systems & Software
Brightree (DME Billing & Sales Order Management)
Availity, Payer Portals
EBridge
ICMS, TruCare
VPN Technologies (Express VPN, Proton)
Microsoft Office Suite, Microsoft Teams
Citrix, Ring Central, Zoom