Maria E.
Senior Medical Insurance Advisor
Open to offersNew to PlatformAbout
Maria E. P., MD, is a seasoned medical professional with over 16 years of experience, specializing in insurance medicine and telemedicine. Based in Santo Domingo, Dominican Republic, she has honed her skills in clinical evaluation, medical auditing, and healthcare information management. Her expertise includes the review of medical records, preparation of comprehensive SOAP notes, and interpretation of diagnostic tests, all geared towards supporting accurate clinical decision-making. Maria is proficient in Electronic Health Records (EHR) systems, such as Tebra and Epic, and is well-versed in ICD and CPT coding, ensuring compliance with HIPAA standards. Her career highlights include leading telemedicine teams and optimizing patient care workflows in the USA at the Brain and Spine Center. In the insurance domain, she has notably directed risk assessments at WorldWide Seguros, improving underwriting processes and managing high-value policies. Committed to excellence, Maria prioritizes patient-centered care and operational efficiency in both remote and in-person settings.
Experience
Senior Medical Assistant
Capital, Brain and Spine Center · 2025 — 2026Led and coordinated the telemedicine clinical team to ensure consistent and optimized workflows for virtual consultations. Supervised follow-up care for patients after minimally invasive spine surgeries, adhering to strict medical protocols. Trained and mentored junior clinical staff to uphold high quality standards. Streamlined complex case coordination through optimized electronic medical record management and remote patient monitoring.Risk Assessment Manager
WorldWide Seguros, S.A. · 2024 — 2024Directed a team of 7 analysts managing technical risk assessments for Life, Health, and Disability portfolios. Maintained strategic communication with clients and partners to ensure business continuity. Enhanced internal underwriting processes to improve the efficiency and quality of technical decision-making.Senior Life Underwriter
WorldWide Seguros, S.A. · 2020 — 2024Executed thorough medical and financial risk assessments for complex individual life insurance policies. Provided training and mentorship to junior analysts within the department. Prepared for and responded to technical underwriting audits while managing high-value policies with support from reinsurance markets.Medical Submanager
WorldWide Seguros, S.A. · 2015 — 2020Delivered medical consultation and guidance to Underwriting and Claims departments for key decision-making. Implemented a continuous audit and monitoring system for high-cost claims, aimed at reducing loss ratios and improving response times for critical clients.Medical Director of Underwriting and Claims
Claria · 2014 — 2015Oversaw operational management and direction for the Underwriting and Claims departments. Optimized departmental processes, enhancing service quality for policyholders and minimizing issues across customer service channels.Underwriting Submanager
WorldWide Seguros, S.A. · 2011 — 2014Conducted medical and technical assessments necessary for international life and health insurance contracts. Developed internal medical underwriting criteria adapted to the behaviors of the regional market.Claims Analyst
WorldWide Seguros, S.A. · 2010 — 2011Reviewed and processed medical claims with respect to the contractual terms outlined in the policies.Medical Internship - Hemodynamics Unit
Hospital General Plaza de la Salud · 2009 — 2010Performed clinical evaluations on patients, managed their medical records, and assisted during invasive diagnostic procedures.
Skills & Expertise
Education
- Postgraduate Diploma in Healthcare Services AuditingUniversidad Iberoamericana (UNIBE) · 2024 — 2024
- Doctor of Medicine (MD)Instituto Tecnológico de Santo Domingo (INTEC) · 2000 — 2008
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