Hey I am Karen

More Info About Me

Results-driven Medical Virtual Assistant with experience in healthcare support, specializing in patient coordination, insurance verification, prior authorizations, and claims management. Proven ability to handle high-volume inbound and outbound calls, maintain accurate medical records, and improve billing processes while ensuring HIPAA compliance. Eager to help healthcare practices improve efficiency and patient satisfaction.

Karen S. Dela Rosa
General Santos, Philippines
karendelarosa322@gmail.com
Freelancer
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My Skills and Competencies

Referrals and Medical Records Management
Data Entry
Insurance Verification
Prior Authorization
Billing and Claims
Appointment Scheduling
Reliability and Professionalism
Customer Service
Customer Relationship Management (CRM) Software
Prescription Management

Certificates

My Experience and Education

  • EXPERIENCE
  • EDUCATION
August 2019 - May 2021
Master of Science in Statistics

Earned 35 credits
University of the Philippines - Diliman

August 2015 - June 2019
Bachelor of Science in Mathematics

Mindanao State University-General Santos
Cum Laude

11/18/2024 - 04/2026
Rheumatology Clinic, Las Vegas, NV
(Medical VA)

Managed appointment scheduling and patient communications
Managed high-volume inbound and outbound patient calls, addressing inquiries, coordinating care, and
conducting timely patient follow-ups
Handled medication prior authorizations in accordance with insurance guidelines and requirements
Verified patient insurance eligibility and benefits
Maintained and updated electronic medical records (EHR) with a high level of accuracy and confidentiality
Prepared, reviewed, and submitted medical claims to insurance providers
Tracked and followed up on claim statuses, proactively resolving denied or pending claims
Processed and posted payments using ERA and EOB, ensuring accurate reconciliation of accounts
Generated and issued billing statements for patients with outstanding balances, supporting effective
collections
Maintained organized and up-to-date billing records to ensure accuracy and timely reimbursements

July 2023 - July 2024
Teleperformance Philippines
(Healthcare Customer Service Representative | Ambetter)

• Offered prompt and professional response to customer inquiries, concerns, and complaints via phone about medical services and records
• Verified customer insurance coverage and benefits, such as copays, deductibles, and coverage limits, and resolved coverage issues
• Enabled clients to schedule visits with the physicians of their choice.
• Recommended physicians or doctors closest to their area based on the customer’s request
• Assist with billing inquiries and payments, setting up payment plans, explaining charges, and resolving payment issues
• Tracked claims and its charges and filed appeals if necessary
• Sustained accurate and up-to-date patient records in compliance with HIPAA regulations, as well as account renewals and cancellations
• Ordered material requests such as ID cards, rewards cards, plan documents, etc.
• Coordinated care between patients, providers, and other departments

March 2023 - July 2023
Teleperformance Philippines
(Customer Service Representative | Netflix)

• Addressed customer inquiries, concerns, and technical issues via phone. Presented a prompt and friendly assistance to ensure a positive customer experience
• Addressed customer inquiries, concerns, and technical issues via phone. Presented a prompt and friendly assistance to ensure a positive customer experience
• Assisted customers with account setup, registration, and login issues. Guided customers through the subscription process and explained different service plans and features
• Walked through the customers in troubleshooting technical issues related to streaming services by providing a step-by-step instructions
• Aided customers with billing inquiries and payment issues; helped customers update their payment methods, cancel subscriptions, or process refunds as per company policies
• Gave assistance with how-to questions and navigating the application
• Referred unresolved customer concerns to designated departments for further assistance

October 2022 - March 2023
Teleperformance Philippines
(Healthcare Customer Service Representative | Wellcare)

• Delivered high-quality customer service by addressing patient needs promptly and courteously. Maintained a calm and professional demeanor, even in high-stress situations.
• Verified patient insurance coverage and benefits such as co-pays, deductibles, and out-of-pocket expenses
• Managed customer accounts, such as updating personal information; helped with plan changes, account renewals and cancellations
• Ordered plan materials upon customer’s request
• Assisted customers with billing inquiries, processed payments, set up payment method, explained charges, and resolved payment issues
• Prescription Management: Assist with prescription refills, prior authorizations, and coordinating with pharmacies.
• Liaised with patients, healthcare providers, and other departments to facilitate comprehensive care.

June 2021 - December 2021
Philippine Statistics Authority - General Santos
(Registration Center Supervisor)

• Managed a group of employees and handled the day-to-day operations of the registration center
• Performed data entry, encoded demographic information, and captured biometric information
• Complied with the directives of the focal person and submitted the required administrative and monitoring reports
• Cascaded official communications to the team personnel
• Delivered an exceptional level of customer service to all applicants by addressing concerns, queries, and complaints
• Troubleshoot basic technical problems encountered during the registration process

My Services

Medical Virtual Assistance

Insurance Verification, Billing and Claims Inquiries, Data Entry and Management, Customer Service

Customer Support

Providing excellent service to customers by addressing inquiries, resolving issues, etc

Administrative Support

Insurance Verification, Billing and Claims, Referrals, Medical Records, etc.


Works

Let's work together !

I am available for freelance projects.
Hire Me

Get In Touch

Address :
General Santos,
Philippines
Email :
karendelarosa322@gmail.com


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