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Novy G. — Mid-Level Healthcare Insurance Verification Specialist from Philippines

Novy G.

Mid-Level Healthcare Insurance Verification Specialist

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

Novy G. is a detail-oriented Healthcare Support Specialist with over four years of experience in the realm of insurance verification and medical administrative support. Specializing in efficiently managing claims processing and patient care coordination, she has a track record of providing robust support to healthcare providers. Novy's expertise includes insurance verification, prior authorizations, and medical documentation management, allowing her to navigate complex insurance portals and Electronic Health Records (EHR) systems with ease. She has served in various roles, including a remote position as an Insurance Verification & Prior Authorization Specialist for a surgery practice, where she ensured compliance with Medicare, Medicaid, and commercial guidelines. Novy has also excelled as a Sr. Medical Admin at an acupuncture clinic, where her responsibilities included handling patient records, conducting insurance benefits validation, and supporting the U.S. Department of Veterans Affairs. Her proficiency with tools like Waystar, Availity, and CharmHealth EHR enhances her ability to provide high-quality patient service in fast-paced healthcare environments. Additionally, Novy has been a vital asset in roles such as a Client Support Specialist at Lumix Health, where she improved claim submissions and portal navigation, facilitating excellent client onboarding and support. Trained in Hotel and Restaurant Management at the University of Mindanao, her diverse background enriches her approach to healthcare insurance claims and customer service.

Experience

  • Insurance Verification & Prior Authorization Specialist

    Surgery Practice · 2025 — 2026
    Verified insurance eligibility and benefits for both outpatient and inpatient surgical procedures. Processed prior authorizations according to commercial, Medicare Advantage, and Medicaid guidelines. Coordinated with payers to confirm coverage details, authorization requirements, and patient cost-sharing. Reviewed CPT and ICD-10 codes to ensure the precision of authorization requests. Communicated the status of authorizations to providers and surgical coordinators while following up on pending requests to avoid delays.
  • Sr. Medical Admin (Back Office | Contract)

    Acupuncture Clinic (via MedVA / Berry Virtual) · 2026 — 2026
    Managed patient records and documentation using CharmHealth EHR, ensuring compliance and accuracy. Conducted insurance verification and benefits validation through various payer portals. Uploaded and organized verification of benefits (VOB) and insurance documents within patient charts. Processed incoming fax documents while ensuring proper indexing in the EHR system. Assisted with claims processing and denial resolutions. Coordinated Requests for Services (RFS) for patients under the U.S. Department of Veterans Affairs (VA) system while providing essential backend administrative support.
  • Client Support Specialist - Healthcare Insurance Claims

    Lumix Health · 2025 — 2025
    Assisted providers in submitting claims and navigating the portal to enhance first-call resolution rates. Monitored claim rejections via Waystar and guided providers on necessary corrective actions. Conducted onboarding sessions for new clients, ensuring successful system setups. Created and managed support tickets, collaborating with technical teams for resolution. Provided updates on claim statuses and educated users regarding billing workflows while performing data entry and lead generation to support business development initiatives.
  • Healthcare Customer Advocate

    Teleperformance Philippines · 2025 — 2025
    Verified insurance eligibility, benefits, and provider information for members. Assessed prior authorization requirements for various procedures, treatments, and medications. Assisted providers in submission processes through portals, fax, and mail. Provided updates on claim statuses and guided necessary next steps for approvals or denials. Escalated urgent cases and coordinated follow-ups to ensure swift resolution.
  • Medical Virtual Assistant

    Physical Therapy Clinic
    Verified insurance eligibility, benefits, and authorization requirements using Availity and payer calls. Initiated prior authorizations for therapy and specialist services. Managed provider calendars, including appointment scheduling and patient reminders while handling patient communication through phone, email, and SMS. Maintained accurate medical records through data entry and organized documentation.

Skills & Expertise

Education

  • Bachelor of Science in Hotel and Restaurant Management
    University of Mindanao - Matina Campus · — — 2016
  • Associate Degree in Hotel and Restaurant Management
    St. Luke’s College of Arts and Sciences Inc. · 2014 — 2016