Gina
Medical Virtual Assistant | US Medical Billing & AR | Prior Authorization | Deni
Verified
Overview
Looking for full-time work (8 hours/day)
at $6.81/hour ($1,344.00/month)
Bachelors of Science in Business Administration major in Financial Management
Last Active
September 19th, 2026 (2 days ago)
Member Since
April 16th, 2017
Profile Description
I am a Medical Billing Specialist with 10+ years of total experience in healthcare billing
and insurance claims — including 9+ years handling Philippine medical billing and insurance
(PhilHealth and HMO claims), and 1 year specializing in full-cycle US medical billing as a
Medical Virtual Assistant. In that US-focused year, I personally handled the complete revenue
cycle: eligibility verification, prior authorization, claims submission, denial management,
and accounts receivable follow-up.
This combination gives me a strong foundation in insurance and claims logic from a decade in
the industry, plus direct, current hands-on experience with US payers, US coding conventions,
and US-specific compliance requirements — so I can ramp up fast without a steep learning curve.
My core expertise includes:
• Insurance verification & eligibility checks
• Prior authorization coordination & submission
• Medical coding & charge entry (ICD-10, CPT, HCPCS)
• Claims submission & follow-up (EDI/paper)
• Denial management, appeals & root cause analysis
• Payment posting & patient billing
• AR reporting, aging analysis & performance tracking
• EHR/EMR data entry, scheduling & patient communication (Medical VA support)
I'm experienced with major EMR/EHR systems and billing clearinghouses, including Kareo and Availity. I take a proactive approach to denial prevention — identifying
trends early and working directly with clinical teams to close documentation gaps before
they turn into lost revenue.
Whether you need a dedicated full-time billing specialist, a Medical VA to manage patient-facing
admin and insurance tasks, or someone to clean up a backlogged AR, I bring reliability, attention
to detail, and a results-driven mindset to every engagement.
WHAT I'VE DONE FOR CLIENTS (US practice, Medical VA role)
Denial Reduction for a Private Clinic
Working with a solo physician practice struggling with a high volume of denied claims, I
audited their denial patterns and identified the most common root causes — including missing
prior authorizations and coding mismatches. I restructured their claims review process,
coordinated with the clinical team on documentation standards, and implemented a denial
tracking system. Within a few months, the practice saw a 20–30% reduction in denial rates,
recovering revenue that had previously been written off.
End-to-End Billing Support for a Solo Physician
I managed the full revenue cycle for a solo physician practice — insurance verification,
prior authorization, charge entry, claims submission, payment posting, and patient billing.
Using Kareo as the practice management system and Office Ally/Availity for clearinghouse
submission, I kept AR days low and ensured claims went out clean the first time, giving the
physician full confidence to focus entirely on patient care.
Top Skills
Accounting » Accounts Receivable
Experience: 10+ years
10+ years total experience in healthcare AR — 9+ years in Philippine insurance and HMO claims follow-up, plus 1 year managing full AR cycles for a US solo physician practice, including aging reports, payment posting, and reducing outstanding balances.
Professional Services » Medical Services » Medical Billing
Experience: 10+ years
10+ years total experience in medical billing — 9+ years handling Philippine medical billing and insurance claims (PhilHealth, HMOs), plus 1 year of full-cycle US medical billing as a Medical Virtual Assistant (charge entry, claims submission, payment posting). Familiar with Kareo, Availity, Optum, Medicare, Medicaid and other commercial payer portals.
Professional Services » Medical Services » Medical Virtual Assistant
Experience: 1 - 2 years
1 year of hands-on experience as a Medical Virtual Assistant for a US healthcare practice. Managed EHR/EMR data entry, insurance eligibility verification, patient scheduling, and full-cycle billing support — including prior authorization, claims submission, denial management, and accounts receivable follow-up. Backed by 9+ years of broader medical billing and insurance experience in the Philippines (PhilHealth, HMOs), giving me a strong foundation to move quickly and accurately in a US setting.
Other Skills
Office and Administration » Microsoft Excel
Experience: Less than 6 months
Accounting » Claims Processing
Experience: 10+ years
10+ years total experience processing healthcare claims — 9+ years with Philippine insurers (PhilHealth, HMOs), plus 1 year handling US claims submission end-to-end (EDI and paper), achieving a 20–30% reduction in denials for a US client through improved claims accuracy.
Customer Support » Insurance » Prior Authorization
Experience: 1 - 2 years
Review scheduled services, referrals, and provider orders to determine if prior authorization is required. Submit prior authorization requests to insurance payers, including all supporting clinical documentation. Follow up with insurance companies to track status and resolve delays or denials. Communicate authorization approvals or denials to patients, providers, and billing staff. Work with clinical teams to collect additional documentation when needed. Ensure all approvals are obtained before the scheduled service date to prevent rescheduling or claim denials. Accurately document all authorization activities in the electronic health record (EHR) or practice management system.
Professional Services » Medical Services » Denial Management
Experience: 1 - 2 years
Review and analyze denied and rejected insurance claims. Determine the root cause of denials like coding, documentation, eligibility, authorization, etc. Initiate appeals and re-submissions with supporting documentation and justification. Track and monitor denial trends to identify recurring issues. Collaborate with coding, billing, and clinical teams to correct and prevent denials. Communicate with insurance companies to clarify denial reasons and resolve discrepancies. Maintain detailed records of denial and appeal activities. Ensure all appeals are filed within payer-specified timeframes. Assist in training staff on best practices for denial prevention. Generate and distribute regular denial management reports to leadership.
Office and Administration » Data Entry
Experience: 10+ years
Office and Administration » Email Management
Experience: Less than 6 months
Office and Administration » Calendar Management » Scheduling
Experience: 1 - 2 years
Answer incoming calls and respond to patient inquiries regarding appointments, services, and scheduling needs. Schedule, reschedule, and cancel patient appointments in accordance with provider availability and clinic protocols. Confirm patient appointments and provide pre-visit instructions. Verify and update patient demographic and insurance information at the time of scheduling. Coordinate referrals, authorizations, and follow-up appointments as needed. Work closely with clinical teams to prioritize urgent or time-sensitive appointments. Notify appropriate staff of no-shows, cancellations, and schedule changes. Maintain accurate scheduling records and ensure compliance with HIPAA and confidentiality policies. Handle high call volumes and multitask in a fast-paced environment. Escalate scheduling issues or conflicts to supervisors or appropriate personnel.
Basic Information
- Age
- 34
- Gender
- Female
- Website
- Sign Up with Pro Account to View
- Address
- DAVAO CITY, DAVAO DEL SUR
- Tests Taken
- IQ
- Score: 110
- DISC
- Dominance: 41
- Influence: 19
- Steadiness: 31
- Compliance: 9
- English
- C1(Advanced)
- Government ID
- Sign Up with Pro Account to View
“For years, I maxed out my hours, got burnt out, and the quality of my work would start to go down. I decided to take the leap, hire correctly, and now it frees up my time to focus on growing the business.”
Tyler Gies
SEE MORE REAL RESULTS“My life has gotten so much better. It changed my life, and I know it can change yours”
- Lukas Rohler
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