Calvinlito L.
Senior Medical Virtual Assistant
Open to offersNew to PlatformAbout
Calvinlito L. is an experienced Medical Virtual Assistant with over five years supporting US-based healthcare providers across sectors including durable medical equipment, podiatry, mental health, and health insurance. He has served as an authorization and insurance verification specialist for CPAP providers, appointment scheduler for podiatrists, therapists, and psychiatrists, and member/provider services representative for a healthcare insurance company. Calvinlito’s scope of work includes submitting prior authorizations for DME rentals and purchases, verifying insurance eligibility and benefits, conducting HIPAA-compliant appointment scheduling with calendar management, and answering member inquiries and claims. He is adept in utilizing tools like Niko Health, Brightree, Salesforce, multiple insurance portals, and EHR platforms such as Tebra, ensuring efficient and accurate data entry and patient intake across diverse healthcare settings.
Experience
Prior Authorization, VOB, Documents Reviewer
ISLEEP, LLC · 2024 — 2026Manage submission of authorization requests for DME rentals and purchases through various channels including portal, phone, and fax. Determine authorization requirements for HCPCS codes by contacting insurance companies. Verify patient eligibility and benefits using the portal or through discussions with insurance representatives. Ensure the validity and compliance of documents by reviewing prescriptions, sleep studies, and face-to-face notes for accuracy.Appointment Scheduler
ACHILLES FOOT AND ANKLE · 2023 — 2023Support podiatrists and nurse practitioners in calendar management by scheduling, canceling, and rescheduling appointments. Input new patient information into the EHR (TEBRA) while verifying insurance details. Address patient queries regarding appointment schedules, locations, accepted insurance plans and provider availability through phone, text, and email. Maintain professionalism in handling a variety of inbound calls and directing them to the appropriate departments.Appointment Scheduler
PATH MENTAL HEALTH · 2022 — 2023Handle patient inquiries about provider availability and accepted insurance predominantly via text messaging, along with some phone calls. Facilitate the scheduling, cancellation, and rescheduling of appointments for telehealth sessions, ensuring compatibility between patients and mental health physicians. Uphold HIPAA compliance, privacy regulations, and patient confidentiality.Authorization Specialist
ADAPTHEALTH, LLC · 2020 — 2021Engage with insurance companies to verify patient eligibility, network status, and authorization requirements for HCPC codes. Collect necessary documents including compliance reports, prescriptions, and face-to-face notes to support authorization requests. Submit prior authorization requests via the portal, fax, or phone, and assist supervisors and fellow VAs by extracting patient orders from the CRM for verification and authorization needs.Member/Provider Services Rep.
HEALTHFIRST, New York USA · 2018 — 2020Provide information regarding health insurance coverage and benefits to both members and providers. Address and process member complaints, appeals, and grievances. Handle claim denials submitted by healthcare providers, offering solutions while giving guidance on appeal and claims submission procedures.Direct US Client
Freelance Virtual Assistant · 2012 — 2013Create content for platforms such as Craigslist, Blogs, and Directories to enhance product visibility online. Conduct Cold Calling for a durable medical equipment product, and apply basic SEO practices to improve search engine presence.Customer Service/Tech Support Rep.
Straight Talk - QUALFON · 2010 — 2011Process requests for mobile phone replacements or orders. Assist customers in changing phone numbers or registering new accounts, and manage refill requests for phone data, call, and text service plans. Troubleshoot issues related to mobile phone functionality.
Skills & Expertise
Education
- BS in Computer Science (Undergraduate)Holy Name University · 2008 — 2010
Photos
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