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Junjie P. — Senior Healthcare Virtual Assistant from Philippines

Junjie P.

Senior Healthcare Virtual Assistant

Philippines 3-6 years
Open to offersNew to Platform
Languages
English
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About

Junjie P. is a Certified Healthcare Virtual Assistant with over five years of experience in supporting U.S. healthcare and insurance operations, primarily excelling in Revenue Cycle Management (RCM). He possesses expertise in managing end-to-end authorization processing, claims management, appeals, and accounts receivable follow-ups. Junjie is proficient in using healthcare systems like eClinicalWorks, Athenahealth, and Epic, and has a proven track record in optimizing workflows to reduce denial rates and quicken reimbursement cycles. His career includes roles at Access Healthcare Services Manila, Inc. as a Senior Claims Specialist, where he managed ABA prior authorizations and coordinated with providers and insurers. Previously serving as a Prior Authorization Specialist, he utilized the SILNA platform for workflow management. At Conduent Business Services Philippines, Inc., he supported U.S.-based medical insurance, handling tasks like eligibility verification and claims dispute resolution. Junjie ensures strict HIPAA compliance while providing exceptional customer service and patient support.

Experience

  • Prior Authorization Specialist

    ACCESS HEALTHCARE SERVICES MANILA, INC. · 2024 — 2026
    Managed prior authorization workflows, including initial, concurrent, and reauthorization processes, using the SILNA platform. Conducted insurance verification and benefits checks, while tracking authorization status across multiple payers. Processed claims and handled billing and payment posting, along with denial management and appeals. Ensured HIPAA compliance and supported customer service and patient support activities.
  • Senior Claims Specialist

    ACCESS HEALTHCARE SERVICES MANILA, INC. · 2022 — 2024
    Oversaw ABA prior authorizations from initial through reauthorization stages across commercial and Medicaid payers. Verified eligibility and submitted requests via payer portals and EMR systems. Coordinated with providers and families to obtain necessary medical records and documentation for medical necessity. Managed denials by conducting appeals and peer-to-peer reviews, while ensuring compliance with HIPAA regulations.
  • Customer Associate Representative

    CONDUENT BUSINESS SERVICES PHILIPPINES, INC. · 2021 — 2022
    Provided support for inbound calls related to U.S.-based medical insurance (BCBS Florida), addressing inquiries about eligibility, benefits, authorizations, and claim appeal statuses. Verified coverage and resolved inquiries using EMR/EHR systems, ensuring accurate patient record updates. Assisted with claims processing and dispute resolution for the Humana Dental account.

Skills & Expertise

Education

  • Bachelor of Science in Agribusiness
    Visayas State University · 2019 — 2020