Junjie P.
Senior Healthcare Revenue Cycle Management Specialist
Open to offersNew to PlatformAbout
Junjie P. is a Certified Medical Virtual Assistant specializing in U.S. healthcare and insurance, with over five years of experience in Revenue Cycle Management (RCM), claims processing, and medical billing. While at Access Healthcare Services Manila, Inc., Junjie P. managed the full lifecycle of insurance claims, from billing submissions and eligibility verification to AR tasks, prior authorizations, and appeals, primarily for pediatric and ABA services. Proficient in critical platforms such as eClinicalWorks, Availity, and Zelis, Junjie P. handled sensitive patient data with HIPAA compliance and worked with EHR/EMR systems. At Conduent Business Services Philippines, Inc., Junjie P. supported BCBS FL and HUMANA dental accounts, verifying benefits and resolving claims. With proven expertise in claims processing and authorization management, he optimizes operational performance in fast-paced healthcare domains.
Experience
Senior Client Partner
ACCESS HEALTHCARE SERVICES MANILA, INC. · 2022 — 2026Managed U.S. health insurance claims, including billing submissions and eligibility verification. Conducted follow-ups on the status of claims, denials, and appeals using portals such as Availity, Zelis, and Echo Payments. Oversaw AR tasks, credit reviews, pre-collections, and correspondence for the PM Pediatrics account. Handled the complete prior authorization lifecycle for ABA services within U.S. healthcare systems, including initial, concurrent, and reauthorizations, and managed appeals and peer-to-peer coordination. Trained in handling sensitive patient information in compliance with HIPAA regulations.Customer Associate Representative
CONDUENT BUSINESS SERVICES PHILIPPINES, INC. · 2021 — 2022Responded to inbound calls for the U.S.-based medical insurance BCBS FL account. Verified medical eligibility, authorizations, benefits, and claim appeal statuses. Acquired experience with EMR/EHR platforms to resolve client issues and update patient information. Managed the HUMANA dental account, providing support on eligibility, coverage, claims processing, and dispute resolution.
Skills & Expertise
Education
- Bachelor of Science in AgribusinessVisayas State University · 2019 — 2020
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