0 viewsjobseeker
Sunshine E. — Senior Healthcare Support Specialist from Philippines

Sunshine E.

Senior Healthcare Support Specialist

Philippines 6+ years
Open to offersNew to Platform
Languages
English
Video Introduction
No video introduction yet
The candidate has not added a video.
Contact information and social networks are private. Connect to unlock.
Hidden

About

Sunshine E. is a dedicated Healthcare Support Specialist with over seven years of experience in the healthcare sector, focusing on medical insurance, customer service, lead generation, and administrative support. Her expertise includes eligibility and benefits verification, claims processing assistance, prior authorization, appointment scheduling, and patient coordination. Sunshine has a proven track record of managing high-volume calls while maintaining customer satisfaction and accuracy. She thrives in fast-paced environments, using tools like CRM systems, EHR, and Healthcare Claims Review to resolve insurance-related issues. Her roles with Blue Cross & Blue Shield and other U.S.-based clients underscore her ability to deliver effective support, streamlined processes, and educated healthcare providers about proper billing procedures. Sunshine's education includes a Bachelor of Science in Secondary Education, majoring in English. Additionally, she is HIPAA and Privacy Act compliant, enriched by her certifications in the U.S. healthcare field.

Experience

  • Lead Generation & Scheduling

    Connect 2 Him · 2026 — 2026
    Made over 100 outbound calls each day to potential clients, presenting home and auto insurance quotes aimed at reducing coverage expenses. Organized appointments with licensed insurance agents and communicated updated quote details to clients.
  • Medical Scribe

    Altamonte Kidney Care Associates · 2025 — 2026
    Executed precise medical documentation within the EHR during patient consultations, capturing medical history, examinations, prescriptions, and treatment plans. Updated patient records and assisted in scheduling follow-up visits.
  • Healthcare Support Specialist

    Blue Cross & Blue Shield · 2018 — 2025
    Oversaw and analyzed over 50 healthcare claim denials daily, ensuring accurate service identification and appropriate plan forwarding for processing and payment. Reviewed CMS-1500 and UB-04 claim forms, providing education to providers on correct billing practices to facilitate accurate claim processing based on patient benefits and coverage. Supported providers and patients with eligibility verification, medical and prescription benefits, prior authorizations, referrals, and inquiries about authorization status both pre-and post-service.

Skills & Expertise

Education

  • Bachelor of Science in Secondary Education major in English
    Talisay City College · 2014 — 2018