Salita M.
Junior Accounts Receivables Collections Specialist
Open to offersNew to PlatformAbout
SM is a seasoned professional in the field of credit and collections, specializing as an Accounts Receivables Collections Specialist at Conifer Health Solutions. In this role, they excel at obtaining medical claim statuses through various communication channels and making collection efforts by identifying denial and underpayments for appeal submissions to secure additional payments. Their commitment to data security is evident through adherence to strict confidentiality procedures including HIPAA guidelines. Previously, as a Referral and Authorization Representative at Access Healthcare, SM managed referral requirements and network participation checks to avoid claim denials, demonstrating expertise in the healthcare sector. With education from the University of Santo Tomas and the University of the East, they hold a Bachelor's in Business Administration with a focus on Marketing. Notably versed in utilizing Google Workspace, SM brings significant experience from roles at Cognizant Technology Solutions and Hinduja Global Solutions, continuously proving adept in managing financial accounts and healthcare processes.
Why hire me
Because I understand the rapid pace and exact standards of US medical practices, and I pride myself on delivering accurate results, compassionate, reliable, focused and highly efficient on delivering results
Experience
AR Collections
Conifer Health Solutions · 2023 — 2026Obtained medical claim status through phone calls, provider portals, emails, and received faxes. Conducted additional collection efforts by identifying true denials and underpayments for appeal submissions, aiming to secure further payments on claims. Reviewed payments using Electronic Remittance Advice/Explanation of Benefits to confirm accuracy of balances owed by insurance carriers and applied patient responsibility amounts. Ensured compliance with data confidentiality procedures, including HIPAA guidelines.Referral and Authorization Representative
Access Healthcare · 2020 — 2023Verified referral requirements for specialist office visits and followed up on referral statuses. Submitted clinical documentation for approvals when necessary, and obtained NPI/TAX IDs from medical facilities. Ensured specialist network participation to prevent claim denials and managed the referral request process, returning requests for additional information as needed.Senior Process Executive
Cognizant Technology Solutions · 2018 — 2020Assisted inquiry for Medicare patients with renal condition. Order Intake for KCI durable medical equipment for Wound careHealthcare Associate
Hinduja Global Solutions · 2016 — 2018Managed inbound calls for both members and providers, assisting in correcting incorrectly processed claims. Provided benefit inquiry information and assigned members to dental offices, while also authorizing Out of Network providers.Customer Service Representative
Convergys · 2015 — 2016Assisted callers with software malfunctions related to Intuit QuickBooks/MFA, including installation and updates. Conducted password resets and payroll inquiries, while also reselling branded meat products and introducing homemade processed meat items.Customer Service and Billing Representative
Transcom · 2015 — 2015Processed payments via debit and credit cards, providing information about bills and promotional packages. Assisted customers with payment-related requests.Shop Assistant
Asian Artefacts Macau SAR · 2005 — 2009Sold antique furniture from China and coordinated shipping arrangements for foreign nationals. Managed bank transactions and provided detailed explanations of items and their origins. Conducted restorations, daily sales summaries, inventory management, and operated the service desk.Cashier
K Servico Trade Inc · 2000 — 2003Processed cash and check payments, verifying the accuracy of transactions and deposit slips. Managed all accountable forms and performed bank transactions, while maintaining inventory and proper handling of official receipts.
Skills & Expertise
Education
- Bachelor of Science in Business Administration major in MarketingUniversity of Santo Tomas · 1997 — 1999
- Bachelor of Science in Business Administration major in MarketingUniversity of the East · 1994 — 1996
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