John Mark Duatin
sirjmduatin@gmail.com
09270349029
PH
About Me
Hi! My name is John Mark Duatin. I graduated with a Bachelor’s Degree in Education in 2019 and started my career as a Customer Service Representative in a Contact Center where I supported US and Canadian clients for an online retail account which is an e-commerce. We process replacement, refunds, track customer's packages, assist them their subscriptions and charges on their account. Assisting customers via phone, email, and chat. After a year being a customer service representative, and having a good performance, I was promoted as a Subject matter expert where I assist newly hired agents after their training.
After two years, I transitioned into the healthcare field as a Medical Virtual Assistant for Billing and Collections for a New York-based company. In this role, I specialized in billing and collections, managing medical claims, resolving insurance issues, filing an appeal, and assisting patients with billing inquiries. I am HIPAA Certified as well.
Basic Information
Full Name
John Mark Duatin
Email Address
sirjmduatin@gmail.com
Phone
09270349029
Location
PH
Education
Education Completed
Bachelor Degree
Institution/School
Kolehiyo ng Lungsod ng Lipa
Field of Study
Education
Graduation Year
2019
Current Enrollment
Graduated
GPA/Grade
Certifications
Achievements
Work & Experience
Company Name 1
ASC STRATEGIC REVENUE LLC.
Job Title
Medical Claims - AR Collections/ Billing
Start Date
15/07/2022
End Date
30/11/2024
Job Description
Claims Processing:
Review and process medical claims submitted by healthcare providers to insurance companies.
Verify the accuracy and completeness of claim information, including patient details, procedures, and billing codes.
Possess a strong understanding of medical coding and billing practices to identify discrepancies or errors in claims.
Specialize in using EMRs/EHR systems for efficient claims management.
Submit claims processed as Out-of-Network (OON) to the Federal NSA Independent Dispute Resolution (IDR) or file appeals with healthcare insurance when necessary.
Insurance Verification:
Verify patient insurance coverage and eligibility before processing claims.
Confirm that services rendered are covered by the patient's insurance plan.
Follow-up on Unpaid Claims:
Monitor and follow up on outstanding claims to ensure timely reimbursement.
Investigate and resolve any discrepancies or denials from insurance companies.
Appeals Process:
Prepare and submit appeals for denied or underpaid claims, providing necessary documentation to support the appeal.
Communication with Insurance Companies:
Communicate with insurance companies to resolve claim issues, clarify information, and obtain authorization for services when necessary.
Patient Communication:
Contact patients to discuss outstanding balances, explain insurance coverage, and set up payment arrangements if needed.
Provide clear and concise explanations of billing statements to patients.
Account Reconciliation:
Reconcile accounts and ensure that payments are accurately applied to patient balances.
Maintain detailed records of all interactions and transactions related to claims.
Compliance with Regulations:
Stay updated on healthcare industry regulations and changes in insurance policies to ensure compliance in claims processing.
Data Entry and Documentation:
Accurately input and update information in billing systems and maintain detailed records of all claims-related activities.
Collaboration with Other Departments:
Collaborate with other departments within the healthcare facility, such as the billing department and medical coding team, to address and resolve billing issues.
Reporting:
Generate and analyze reports related to claim status, collections, and accounts receivable to assess the financial health of the healthcare facility.
Company Name 2
ALORICA INC.
Job Title
Customer Service Representative / Subject Matter Expert
Start Date
01/10/2029
End Date
01/02/2022
Job Description
Responsibilities:
Responding to Customer Inquiries: Handling customer inquiries and resolving issues through email, phone, and chat support.
Providing Product Information: Offering detailed information about products, including features, specifications, and pricing.
Order Processing: Assisting customers with placing orders, tracking shipments, and processing returns or exchanges.
Resolving Complaints: Addressing and resolving customer complaints in a professional and timely manner.
Promoting Customer Loyalty: Building rapport with customers to promote customer loyalty and repeat business.
Adhering to Policies: Ensuring compliance with company policies and procedures related to customer service and data privacy.
Meeting Service Levels: Meeting or exceeding service level agreements (SLAs) for response times and customer satisfaction.
Providing Feedback: Providing feedback to management on customer issues and suggestions for improvement.
Maintaining Records: Keeping accurate records of customer interactions, transactions, and inquiries.
Training and Mentoring: Assisting in training and mentoring new customer service representatives as a Subject Matter Expert.
Hourly Charge
Employment Type
Professional Skills
Technical Skills
Creative Skills
Business Skills
Communication