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Carmina Priol

@carminapriol

Experienced claims specialist with strong analytical and problem-solving skills.

Philippines
Message

What I'm looking for

I am looking for a role that offers growth opportunities and values teamwork.

I am a dedicated claims specialist with over three years of experience in the healthcare industry, specializing in medical claims processing and customer service. My journey began at Conduent, where I honed my skills in handling medical claims, effectively communicating with healthcare providers, and addressing their inquiries regarding claim processes. My attention to detail and strong organizational skills allowed me to excel in this role, ultimately earning recognition as the top agent for my performance.

Currently, I serve as a team leader at Ista Solutions, where I oversee a medical billing account. My responsibilities include submitting claims, resolving discrepancies, and ensuring accurate payment posting. I take pride in my ability to lead a team and maintain high standards of service, which has resulted in significant incentives from clients for our excellent performance. I am passionate about continuous improvement and strive to enhance the efficiency of our processes.

Experience

Work history, roles, and key accomplishments

IS

Team Leader in Medical Billing

Ista Solutions

Jan 2022 - Present (3 years 6 months)

Led a team in a Medical Billing account, responsible for submitting and fixing rejected claims, monitoring claim statuses, and following up on unpaid or denied claims. Managed payment posting from various insurances and ensured accurate system entry, along with encoding PDPM scores and diagnoses.

Education

Degrees, certifications, and relevant coursework

CC

Caramoan Community College

Bachelor of Elementary Education, Elementary Education

Grade: 1.59

Graduated with Academic Distinction, achieving a General Weighted Average (GWA) of 1.59. The program provided a comprehensive understanding of elementary education principles and practices.

Tech stack

Software and tools used professionally

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