K
Kherwin Mangubat
About
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Manila, Metro Manila, Philippines
Résumé
Jobs
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- CPayment Reconciliation SpecialistConnext SolutionsJan 2024 - Current (2 years 5 months)• Conduct detailed payment audits to identify underpayments, misapplied, and unapplied payments, ensuring maximum reimbursement for providers. • Resolve payment discrepancies, including underpayments, contractual variances, and incorrect member cost-sharing. • Post payments, adjustments, and reversals accurately to maintain account integrity. • Prepare and submit appeals for denied and underpaid claims. • Investigate outstanding balances and coordinate with payers to reduce AR aging. • Perform collections activities in line with negotiated agreements between providers and insurance payers.
- ASenior Client PartnerAccess Healthcare (Athena)Jan 2021 - Jan 2024 (3 years 1 month)• Managed claims follow-up for denials, payments, and authorizations. • Resolved claim discrepancies through coordination with payers and internal teams. • Reviewed clinical documentation and submitted appeals to overturn denials. • Verified authorizations/referrals to prevent claim delays. • Maintained provider data accuracy to reduce rejections.
- ATeam Manager / Healthcare AdvocateAlorica Inc. (UnitedHealthcare)Jan 2019 - Jan 2021 (2 years 1 month)• Led a team of 15–18 agents, ensuring performance and quality targets. • Conducted coaching, call audits, and calibration sessions. • Assisted members with eligibility, billing, and healthcare navigation. • Explained benefits including copayments, coinsurance, and out-of-pocket costs.
Education
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- CBachelor of Science in Secondary Education (Major in History)City University of PasayJan 2018Board Passer