ANNABELLE GUERRERO
Regina,SK
Summary
Continuing Care Assistant International student with strong interpersonal skills eager to secure entry-level. Patient and reliable committed to provide highest standard of care. Specializing in care for elderly and their families.
Overview
13
13
years of professional experience
Work History
Medical Claims Adjudicator
Metlife
09.2015 - 07.2023
- Adjudicate medical claims from Dubai Health Authority Providers in accordance with policy terms and conditions.
- Monitor turnaround time and ensure claims are paid and settled within required time frame.
- Monitor daily Fast Track Provider claims' report to the Team Leader.
- Distribute claims within the team and assist in reaching the weekly team quota.
- Collaborate with Network Team to ensure tariffs are updated in the system.
Medical Claims Team Leader
Neuron LLC
06.2013 - 08.2015
- Communicated with staff, leaders and peers to coordinate successful collaboration with other departments.
- Supported the manager in implementing and monitoring team objectives and reaching daily quotas.
- Delegated tasks among team members in accordance with set target.
- Monitor individual performance and ensure it meets quality and quantity objectives.
- Assisted in planning and implementing preventative measures to lessen team errors and processing issues.
- Provide training and orientation for newly hired claims executives.
Medical Claims Executive
Neuron LLC
06.2010 - 06.2013
- Handled medical claims consistent with client and corporate policies, procedures, best practices and regulations.
- Followed daily timelines and targets for processing claims.
- Worked within a computerized claims processing program that helps flag any claims requiring special attention.
- Reviewed patients' medical histories for pre-existing conditions, focusing on the specific table of benefits, exclusions, and table of benefits.
Education
Bachelor of Science - Nursing
Catanduanes State University
Virac, Catanduanes, Philippines04.2007
Skills
- Proven (13 years) experience in medical administration
- Proficient in Microsoft Office applications such as Word, Outlook, and Excel
- Effective communication in the English language
- Registered Nurse (Philippines)
- with valid certification on First Aid/CPR-C, Transfer, Lift, Reposition (TLR), PART Intermediate course, Food Safety, and WHMIS
Timeline
Medical Claims Adjudicator
Metlife
09.2015 - 07.2023
Medical Claims Team Leader
Neuron LLC
06.2013 - 08.2015
Medical Claims Executive
Neuron LLC
06.2010 - 06.2013
Bachelor of Science - Nursing
Catanduanes State University
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