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Rachel L. — Senior Medical Billing Specialist from Philippines

Rachel L.

Senior Medical Billing Specialist

Philippines 6+ years
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About

Rachel P. is a proficient Senior Medical Billing Specialist at Connext Global Solutions. She has extensive expertise in healthcare billing, emphasizing her experience in insurance verifications and prior authorization processes. At Connext, she ensures adherence to HIPAA standards while managing patient data, coordinating with healthcare providers, and meeting critical deadlines to maintain service level agreements. Rachel's role in the healthcare industry involved supporting organizational objectives by verifying insurance eligibility and benefits, processing authorizations, and communicating vital information to both providers and patients. Her previous positions at Everise Philippines and Booking Go enhanced her customer service capabilities, supporting her goal to contribute effectively to team environments. Rachel holds a BSBA in Marketing Management and has completed education in Hotel Management, which complements her interdisciplinary strengths in customer engagement and business operations.

Experience

  • SENIOR MEDICAL BILLING SPECIALIST

    Connext Global Solutions · 2025 — Present
    Primarily focused on ensuring compliance with HIPAA standards in handling patient Protected Health Information (PHI). Responsible for accurate insurance eligibility and benefits verification as well as managing and processing prior authorizations punctually. Engaged in outbound communication with payer's authorization departments and submitted necessary documentation to support authorization requests. Maintained adherence to Service Level Agreements (SLAs) by prioritizing urgent tasks, monitoring authorization deadlines, and liaising with healthcare providers for required clinical and patient data.
  • Healthcare Customer/Provider Representative

    Everise Philippines · 2022 — 2025
    Facilitated communication with clients and healthcare providers using Slack, addressing patient cases and authorization status updates. Provided detailed information regarding members' insurance benefits, as well as assisted in grievance and appeal management. Offered technical support related to ambetterhealth.com, guiding users through account setup, claims processing, and filing grievances.
  • Customer Service Representative: Booking Go

    Convergy’s/Concentrix Philippines · 2017 — 2020
    Oversaw the reservation process for rental vehicles, ensuring customer needs were met and satisfaction was maintained.
  • Customer Service Representative: Amazon.com

    Alorica Company · 2015 — 2017
    Delivered precise information to customers to assist them in finding suitable products. Managed issues related to product replacements and handled reimbursements for defective items.

Skills & Expertise

Education

  • BSBA Major in Marketing Management
    Golden Link College · 2011 — 2013
  • Bachelor of Science in Hotel Management
    Access Compute College · 2009 — 2011

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