Raisa Lynn Q.

I am a Licensed Physical Therapist in the Philippines with extensive expertise in healthcare and administration. My diverse skill set spans physical therapy, medical insurance, claims and billing, customer service, sales and retention, communication, and quality analysis. I hold a HIPAA Certification (Certificate Number: 1260972), underscoring my commitment to maintaining the highest standards of patient privacy and data security. My experience in operational management, training, and team leadership equips me to optimize processes and achieve both organizational and patient care goals effectively. Core Competencies: Prior Authorization & Insurance Verification: Proficient in managing prior authorization and insurance verification to ensure accurate benefits and eligibility determinations, facilitating effective patient care. Healthcare Billing & Claims Management: Extensive experience with billing procedures, including Workman’s Compensation, No Fault insurance, and commercial insurances. Skilled in resolving discrepancies and streamlining operations. Customer Service & Sales: Adept at addressing customer inquiries, resolving billing issues, promoting products, and driving sales and retention strategies. Quality Analysis & Process Improvement: Proven ability to enhance team performance and reduce errors through targeted training and quality analysis initiatives. Operational & Team Management: Effective in leading teams, optimizing processes, and achieving organizational objectives through strategic management. Professional Experience: Admin Training Manager, Quality Analyst, and Claims & Billing Specialist Evolve Physical Therapy Managed Billing Processes: Streamlined and oversaw all billing procedures for Workman’s Compensation, No-Fault, and Commercial Insurances. Enhanced team proficiency by 20% through process optimization and targeted training, resulting in a 15% reduction in billing errors. Prior Authorization & Insurance Verification: Managed prior authorization and insurance verification for Workman’s Compensation, No-Fault Insurance, and Commercial Insurances. Ensured accurate and compliant benefit determinations. Claims Management: Directed the submission and follow-up of claims, focusing on Workman’s Compensation, No-Fault Insurance, and Commercial Insurance. Resolved discrepancies, ensuring accurate and timely reimbursement, and improved operational efficiency. Compliance: Ensured strict adherence to industry regulations and internal policies across all billing and claims processes. Implemented procedures to maintain compliance and mitigate risks. Virtual Front Desk Operations: Handled patient inquiries about bills, resolved scheduling issues, and addressed general questions, delivering exceptional customer service. Training & Quality Analysis: Developed and delivered training programs on billing procedures, claims management, and compliance. Conducted quality analysis to optimize processes and increase accuracy. HR Support: Assisted with HR functions, participated in interviews, and supported recruitment and onboarding processes. Patient Advocacy, Appointment Setter & Prior-Auth. Specialist MedRisk & Access Healthcare Coordinated patient appointments for Workman’s Compensation cases, aligned provider schedules with patient needs, and managed insurance approvals by verifying eligibility and obtaining prior authorizations. Customer Sales & Billing Specialist VXI Global Solutions (AT&T) Addressed customer service inquiries, resolved billing issues, managed billing questions, and promoted AT&T products. Met sales targets and implemented strategies to enhance customer satisfaction and loyalty. Retention & Sales Specialist Concentrix (SiriusXM) Drove sales, managed billing inquiries, and focused on customer retention. Identified customer needs, recommended SiriusXM products, and developed strategies to retain customers and reduce churn. Physical Therapist & Sports PT UPHSD Medical Center and Las Piñas Doctor's Hosp Conducted evaluations, developed treatment plans, and implemented interventions for patients with physical impairments. At Loyola Meralco Sparks Football Club, assessed, treated, and rehabilitated players' injuries, and developed injury prevention programs.