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Vince Aize Santos
About
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Antipolo, Calabarzon, Philippines
Résumé
Jobs
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Quality AnalystNeolytixJul 2025 - Current (1 year)• Conduct comprehensive quality audits across Mental Health/Behavioral Health, Nephrology, Surgical, and Plastic Surgery accounts • Evaluate end-to-end workflows including payment collection, patient scheduling, appointment management, intake coordination, prior authorization, and prescription refill requests • Review and validate insurance eligibility and benefits (E&B) to ensure accuracy and compliance with payer guidelines • Ensure adherence to HIPAA regulations, client SOPs, and RCM standards • Provide actionable feedback and coaching to improve agent performance, documentation accuracy, and service quality • Identify process gaps and recommend improvements to reduce denials, delays, and operational inefficiencies • Collaborate with ope- Quality Analyst / Assistant Team Lead / SmeGeBBS Healthcare SolutionsNov 2021 - Jul 2025 (3 years 9 months)• Supported Dialysis accounts, specializing in insurance eligibility and benefits (E&B), prior authorization, and retro authorization processing • Managed and reviewed prior and retro authorizations, ensuring timely approvals and minimizing claim denials • Validated insurance coverage, coordination of benefits (COB), and payer requirements for accurate billing • Investigated and resolved complex cases involving authorization discrepancies and coverage issues • Conducted quality audits to ensure compliance with payer guidelines and regulatory standards • Served as Subject Matter Expert (SME) for escalations related to eligibility and authorization concerns • Assisted in team leadership through coaching, performance monitoring, and process im
- ICustomer Service RepresentativeIgrant Marketing ServicesJan 2020 - Oct 2020 (10 months)• Conducted outbound calls to verify patient information for Medicare and Medicaid accounts • Ensured accuracy of patient data while maintaining compliance with regulatory standards • Delivered professional and efficient service in a high-volume call environment
Education
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- Bachelor of Science in PsychologyOur Lady Of Fatima UniversityJan 2020 - Jan 2021 (1 year 1 month)
- AAccountancy and Business Management (SHS)Apec SchoolJan 2018 - Jan 2020 (2 years 1 month)