Joshua A.
Mid-Level Medical Billing Specialist
Open to offersNew to PlatformAbout
Joshua Anthony B. is a seasoned Medical Billing Specialist and Customer Service Representative with extensive experience in the healthcare and telecommunications industries. Most recently, at OUTSOURCE ACCELERATOR, he excelled in claims processing, where he accurately prepared and submitted insurance claims, managed collections, and supported patients with billing inquiries. Joshua's proactive follow-up practices were instrumental in optimizing reimbursements and maintaining financial stability for medical providers. His role required collaboration with the Admin Billing Manager to ensure efficient operations and timely account management. Previously, Joshua served as a Customer Service Representative at AFNI PHILIPPINES on an insurance campaign with Centene Health Insurance, where he updated patient records, verified insurance coverage, and provided detailed explanations of coverage to enhance customer understanding. His meticulous approach contributed to improving claims success rates, minimizing denials, and increasing cash flow efficiency. Joshua's educational background includes studies in pharmacy at Our Lady of Fatima University.
Experience
Medical Claims Specialist
LEGATO HEALTH TECHNOLOGY · 2021 — 2022Assisted patients with inquiries about medical bills and insurance coverage. Provided clear and empathetic explanations regarding healthcare processes. Ensured compliance with HIPAA regulations to maintain patient confidentiality. Reviewed and processed medical insurance claims while verifying the accuracy and completeness of documentation.Customer Service Representative
Centene Health InsuranceUpdated patient records, verified insurance coverage and benefits, and explained coverage details to patients. Managed the Pharmacy Line of Business, providing comprehensive information on insurance details, plan tiers, and relevant requirements. Processed prior authorization forms by documenting and submitting them to the necessary department for review.Medical Billing Specialist
OUTSOURCE ACCELERATORPrepared and submitted insurance claims with attention to compliance standards. Monitored accounts receivable and collaborated with the Admin Billing Manager to manage overdue accounts. Actively handled patient responsibility collections to support cash flow. Conducted thorough reviews of documentation and coding to ensure accurate claim submission and minimize denials. Communicated with patients regarding financial responsibilities and billing inquiries. Worked closely with the Admin Billing Manager on timely and accurate billing task completion.Customer Service Representative
AFNI PHILIPPINESDelivered comprehensive customer support to Telco customers through phone, email, or chat channels. Addressed inquiries involving billing, account management, service plans, and technical issues. Diagnosed and resolved technical disruptions, documenting all interactions in the CRM system. Contributed to improvements in claims success rate through effective claim review strategies and collaborative departmental efforts.
Skills & Expertise
Education
- Bachelor of Science in PharmacyOUR LADY OF FATIMA UNIVERSITY- Valenzuela Campus
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