John Albert Legaspi,Rn Email and Phone Number

• Increases management's effectiveness by recruiting, selecting, orienting, training, coaching, counselling, and disciplining managers; communicating values, strategies, and objectives; assigning accountabilities; planning, monitoring, and appraising job results; developing incentives; developing a climate for offering information and opinions; providing educational opportunities.• Builds company image by collaborating with customers, government, community organizations, and employees; enforcing ethical business practices.• Accomplishes subsidiary objectives by establishing plans, budgets, and results measurements; allocating resources; reviewing progress; making mid-course corrections.• Developing a pricing strategy that maximizes profits and market share but considers customer satisfaction.• Identifying new customers.• Supporting sales and lead generation efforts.• Understanding and developing budgets, including expenditures, research and development appropriations, return-on-investment and profit-loss projections.• Compiling lists describing our organization's offerings.• Developing and managing advertising campaigns.• Organizing company conferences, trade shows, and major events.• Building brand awareness and positioning.• Evaluating and maintaining a marketing strategy.• Directing, planning and coordinating marketing efforts.• Communicating the marketing plan.• Developing each marketing campaign from start to finish.• Researching demand for the organization's products and services.• Evaluating competitors.• Handling social media, public relation efforts, and content marketing.

• Request to insurance company for any approvals.• Making sure to secure 99% approval rate.• Gather and accurately record insurance information from patients. • Informing the patient on how much benefits and coverage they have.• Organizing and filling of all medical and insurance documents.• Preparing approval ahead of time.• Preparing financial treatment plan and present plan option to patient at end of their appointment• To Train and educate staff in insurance matter• Assisting invoicing department in insurance processing and billing.• Ensuring coverage of claims guiding staff for correct usage of claim forms approval paper.• Making report, update insurance collection. Reconciliation with insurance company regarding pending payments.• Data Entering / Submission / Re-submission / Checking for remittance advice using ECLAIMLINK• Coordinate with different insurance company for any concern.• Coordinate with out of the network insurance company for inclusion of the facility to their network.• Preparing / Filling insurance contract.• Smoothly running insurance operation.

Claims Analyst- Adjudicate and process Claims within the agreed company service level agreement- Making sure that the agreed discount for each hospital is properly applied- Encoding each claims in an accurate manner with speed for insuring the completeness of each batches before the given deadline.- Reviews all (Out Patient and In Patient) medical reports and billing for any discrepancy such us unregistered medications, not covered services, over charges, wrong discount on services and medications, wrong deductibles, no prior approval for services that needs approval, duplicated invoices, unjustified medical services and medications.- Clarify, review and resolves any medical issue with our medical doctors, supervisor and claim manager.- Reporting any possible fraud and abuse for further investigation.- Giving support to other staff for any issue regarding Approval, Billing and Insurance Matter.- Training newly hired employee for Claims Processing and making sure they follow the adjudication Policies and Procedure set by the management.- Auditing and finalizing the report for final settlement.- Ensure stipulated service standards and qualities are met.Approval Department- Giving approval or rejection for Outpatient, Dental and Optical request thru fax and online approval system in accordance to insurance regulation by the Council of Cooperative Health Insurance.- Requires dealing with in-patient whenever needed.- Respond to customer enquiries accurately and professionally and if necessary, liaise with other departments for support to ensure an efficient and professional response is given thereby achieving customer satisfaction