My name is Benjielyn Paras - Roda and I've been in a BPO industry for almost 10 years and all of the accounts that I handle is relating to Healthcare and Insurance , At first I am a doctor's scheduler wherein my Main role is to secure pre authorization, coordinate with patient/customer who badly needed to see that doctor for the day , I also handle claims adjudication wherein I handle simple claim processing when it comes to medical , Checking all the necessary Medical Records if valid and all possible information needed is on file , One of my role is to also ensure that they do have specific benefit to what they're claiming for such as ER visit Inpatient stay or Outpatient Surgery with that being said I am knowledgeable about benefits and eligibility as well as what medicare/medicaid cover . I also have handle CMS Guidelines to make sure proper codings are being used for billing. after 9 years in a bpo industry I have move my expertise as a VA , experience to handle scheduler wherein I have to make sure there is a applicable Caregiver who will be able to take care of client in a day to day basis. My main role is to make sure that the caregiver I am assigning too is well trained for a specific client, as we have clients who needs lifting or help in toiletting, its also different if client just need companionship. making sure caregiver was able to clocked in and clocked out on time also making sure that if a case to case basis there is an emergency or caregiver calling off there will be an available caregiver
In my 10 years experience as a coordinator I already know that in and out of US healthcare system .
I am trained top used Axiscare , Dynamics Quo, Alaya care, 8Salesforce and Money more. I am hoping to hear from you
