Maranesa N.
Mid-Level Healthcare Administrative Specialist
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Maranesa N. is a seasoned professional in healthcare administrative support with over six years of experience specializing in eligibility verification, pre-authorization management, and claims processing. Her proficiency in maintaining HIPAA-compliant practices and ensuring accurate documentation has been integral to supporting both providers and patients. Maranesa has adeptly managed disability claims with the VA and SSA, enhancing approval outcomes through strategic case development while guiding veterans through complex procedures. In her role with Optum Global Solutions in Manila, she demonstrated expertise in managing benefits verification and authorization processing, ensuring thorough compliance in claims management. Maranesa holds a Bachelor of Science in Respiratory Therapy from Perpetual Help College of Manila, underpinning her capability in medical ethics and patient care practices. Her knowledge extends across multiple healthcare systems and productivity platforms, including Optum Provider Services workflow, AthenaOne, and Salesforce, enhancing care coordination and client support operations.
Experience
Patient Engagement & Care Coordination
null · 2024 — 2026Facilitated patient engagement through tailored education and proactive outreach. Coordinated multidisciplinary teams to enhance care delivery and maintain continuity of service. Ensured compliance with healthcare standards and HIPAA regulations while documenting patient interactions and care plans. Provided empathetic support and communicated effectively with patients and families. Streamlined workflows for eligibility verification and scheduling, and monitored patient satisfaction to uphold quality standards.Client Care & Account Specialist
Trajector Medical / Disability Remote · 2021 — 2024Assisted over 200 veterans with VA disability and SSA claim processes, ensuring compliance with HIPAA regulations. Collaborated with attorneys to gather medical evidence for Social Security hearings. Managed claim uploads and performed pre-invoice audits to verify financial accuracy. Advocated for clients and contributed to strategic case development to enhance approval rates.Customer Service Representative – Provider Services
Optum Global Solutions Manila · 2020 — 2021Handled benefits verification and eligibility checks for patients across various insurance plans. Managed service authorizations to facilitate timely patient care. Reviewed provider claims for compliance and accuracy in reimbursement. Maintained rigorous standards of detail and adherence to organizational policies.
Skills & Expertise
Education
- Bachelor of Science in Respiratory TherapyPerpetual Help College of Manila · — — 2013