Shiena J.
Mid-Level Healthcare Virtual Assistant
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About
Shiena J., based in Muntinlupa City, Philippines, is a seasoned Healthcare Virtual Assistant with over 3.5 years of experience working with US insurance and patient support. Her extensive expertise in prior authorization has been honed while managing end-to-end medication and service requests, ensuring comprehensive clinical documentation and expediting urgent patient needs. At Alorica, she maintained strict HIPAA compliance and performed meticulous identity verification using authenticators and Power of Attorney guidelines. Shiena adeptly navigated complex insurance plan structures and pharmacy benefits, enhancing member understanding with clear explanations of Explanation of Benefits (EOB) statements. Proactive and precise, she efficiently followed up on pending authorizations to minimize patient wait times. As an independent developer since March 2025, she has mastered Zoho CRM for healthcare workflow design, extensively uses Google Workspace for data organization, and demonstrates adaptability to Australian and New Zealand healthcare standards.
Experience
Healthcare Business Process Associate
Alorica · 2021 — 2025Oversaw complete prior authorization requests for medications and services, ensuring thorough clinical documentation for efficient EMR/EHR processing. Upheld strict HIPAA compliance by verifying patient identities through authenticators and Power of Attorney (POA) before any data disclosure. Conducted dual-skill support by performing state-transition eligibility checks and updating accounts. Tracked pending prior authorization requests and executed prompt follow-ups using assigned reference numbers. Facilitated urgent requests to guarantee immediate patient care and reduced waiting times. Informed members about complex insurance structures, encompassing deductibles, initial copays, gap coverage, and catastrophic phases. Clarified Explanation of Benefits (EOB) statements, medication coverage, and accumulated costs to patients. Provided compassionate and clear updates to patients navigating the insurance process.Virtual Assistant Transition & Self-Study
Independent Development · 2025 — PresentAcquired mastery of Zoho CRM to create healthcare workflow layouts and lead management systems. Utilized Google Workspace (Sheets/Docs) for effective data organization and employed Canva for professional visual communications. Engaged in studies of Australian and New Zealand healthcare standards to offer seamless support to global clients.
Skills & Expertise
Education
- High School Graduate (Grade 12)Saint Bernadette College of Alabang · — — 2019