Patricia C.
Mid-Level Healthcare Claims Specialist
Open to offersNew to PlatformAbout
Patricia C. is an experienced professional specializing in healthcare administration, with a strong background in A/R collections, insurance verification, and claims management. At ASC Strategic, LLC, she managed patient scheduling for surgical procedures, coordinated with clinical staff and surgeons, processed insurance authorizations, and ensured meticulous recordkeeping through the HST EMR system. Patricia handled both pre- and post-operative patient communications, conducted satisfaction surveys, and worked closely with attorney offices on appeals and collections. During her tenure at Imagenet Philippines Inc., she addressed healthcare provider inquiries, analyzed claims for compliance, resolved denials, and maintained comprehensive documentation. Her earlier roles at Gebbs Healthcare Solutions and Conduent focused on verifying eligibility and benefits for dental and medical claims, utilizing platforms such as Availity, and providing customer service in the insurance domain. She also brings experience in the food service industry, offering customer support and order management at TaskUs.
Experience
A/R Collections
ASC Strategic, LLC · 2025 — 2025Coordinated surgical scheduling at an ASC facility, working closely with surgeons and clinical staff. Verified insurance coverage and managed approved authorizations to ensure readiness for procedures. Uploaded and maintained patient documents and authorization records using the HST EMR system. Reached out to patients before and after operations to deliver instructions and gather satisfaction feedback. Contacted insurance companies, patients, physician offices, attorney offices, and third-party payers to address aged and past due balances and perform collection activities. Documented all communications in the billing system and prepared appeal files with attorney office coordination to support collections.Claims Specialist
Imagenet Philippines Inc. · 2024 — 2025Handled provider calls concerning claim status, denials, and resubmissions. Reviewed and analyzed provider-submitted claims for accuracy and compliance with insurance policies and regulatory guidelines. Supported providers in correcting and resubmitting denied or returned claims for adjudication. Investigated and resolved discrepancies, duplicate denials, and processing errors on claims. Maintained comprehensive documentation of claim follow-ups and provider communications.Customer Service Representative
TaskUs · 2023 — 2024Supported customers in placing, modifying, and tracking food orders via phone or online platforms. Addressed inquiries, complaints, and delivery concerns, ensuring timely interactions. Processed refunds, replacements, and adjustments based on company policies.Insurance Verification & Claims Specialist
Gebbs Healthcare Solutions · 2019 — 2023Managed dental accounts for Dental Care Alliance by verifying patient eligibility and benefits with various insurance providers. Coordinated with patients to confirm appointments, address inquiries, and provide customer service. Ensured accuracy of insurance information to enable efficient claims processing and reduce denials.Insurance Verification & Claims Specialist
Conduent · 2017 — 2019Responded to inbound calls from healthcare providers by verifying eligibility and benefits for patients with BCBS Florida insurance. Guided providers through claim denials and the appeal process, resolving issues related to eligibility, procedure code validity, and discrepancies. Utilized the Availity portal to check patient insurance eligibility, review claim status, and support providers with platform functionalities.
Skills & Expertise
Education
- Bachelor of Science in Information TechnologySan Sebastian College · 2015 — 2017
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