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Keeshia M. — Mid-Level Medical Claims Analyst from Philippines

Keeshia M.

Mid-Level Medical Claims Analyst

Philippines 6+ years
Open to offersNew to Platform
Languages
EnglishTagalog
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About

Keeshia M. is an accomplished medical professional with a robust background in healthcare billing and claims analysis. Holding a Bachelor in Agriculture Technology from the University of Rizal System, she has harnessed her keen attention to detail over five years of healthcare experience. At Med-Metrix Philippines, Keeshia functioned as a Medical Claims Analyst/Biller, excelling in the end-to-end process of managing hospital and professional claims, dispute resolution, and minimizing denials. Her mastery in using tools such as the EPIC System and Microsoft Office Suite ensures precise and efficient claim submissions. During her tenure at NTT Data Services Philippines and AskVelma-Ascend Vision, she honed her skills as an Insurance Verification Specialist, leveraging insurance portals to streamline workflows and verify patient eligibility. Known for her strong compliance knowledge and insights into complex insurance policies, she plays a pivotal role in enhancing financial outcomes within medical practices.

Experience

  • Medical Biller (Ophthalmology)

    AskVelma-Ascend Vision · 2025 — 2026
    Addressed unprocessable and rejected claims by entering necessary diagnostic codes and patient information. Verified eligibility and claims status through insurance portals while facilitating communication with patients regarding active insurance updates and payment reminders.
  • Insurance Verification Specialist

    MEDVA · 2024 — 2025
    Conducted outbound calls to insurance companies to verify patient eligibility and Out-Of-Pocket payments. Confirmed patient coverage before service dates and clarified any inactive policies.
  • Medical Claims Analyst/Biller (Professional Claims)

    MED-METRIX PHILIPPINES · 2022 — 2024
    Executed the end-to-end process of medical claims for patients, utilizing insurance portals. Engaged with insurance providers to verify reimbursement payments and analyzed claims for status. Managed disputes and rejections, submitting corrections as needed.
  • Medical Claims Analyst/Biller (Hospital/Facility Claims)

    NTT DATA SERVICES PHILIPPINES · 2021 — 2022
    Managed the complete medical claims process for patients. Used insurance portals and contacted insurance providers to confirm reimbursement payments. Analyzed claim status and gathered payment information, while handling disputes and reconsiderations.
  • Customer Service Representative Inbound (Medicare)

    THE RESULTS COMPANIES · 2020 — 2021
    Responded to calls from Medicare members regarding eligibility status and located appropriate PCPs within patients' areas.
  • Customer Service Representative Inbound (Providers, Member, Brokers and Third-Party Billers)

    CONCENTRIX · 2020 — 2020
    Handled phone inquiries from Providers, Members, Brokers, and Third-Party Billers. Assisted with Medical Claims and verified prior Authorization. Managed medication order status, eligibility, and coverage checks.

Skills & Expertise

Education

  • Bachelor of Agriculture Technology
    University of Rizal System · 2013 — 2017
  • Highschool Graduate
    Antipolo City Antipolo National High School · 2006 — 2010

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