jhonathan agapito
@jhonathanagapito
Medical claims specialist with five years’ experience in claims processing and denials management.
What I'm looking for
I am a dedicated medical claims specialist with five years of hands-on experience processing, investigating, and resolving healthcare claims to ensure timely payment and regulatory compliance. I have worked in hospital billing and professional billing environments, where I managed claim verification, coding, appeals, and follow-up with providers and payers.
My technical strengths include proficiency with EPIC and professional billing systems, experience with ICD-9/ICD-10, CPT, and HCPCS coding, and a consistent track record of reducing denials through careful adjudication and appeal writing. I am detail-oriented, strong in communication, and adept at collaborating with clinical teams and insurers to correct and resubmit claims.
I hold a Bachelor of Science in Management Information Systems and additional certification coursework; I am committed to continuous learning, maintaining compliance with healthcare regulations, and delivering accurate, efficient claims processing that improves revenue cycle performance.
Experience
Work history, roles, and key accomplishments
Medical Claims Specialist
Meadows Eye Health Care
Nov 2024 - Feb 2026 (1 year 3 months)
Processed and reviewed medical claims for accuracy and completeness, investigated and resolved suspended claims, and managed appeals to recover denied or underpaid claims, improving claim resolution timeliness.
Medical Claims Specialist
KMC Mag Solutions / Health Rise
Oct 2023 - Nov 2024 (1 year 1 month)
Reviewed and processed medical claims, tracked outstanding claims and followed up with payers, and analyzed denials to implement corrective actions and ensure regulatory compliance.
Medical Claims Specialist / QA Specialist
UPenn Hospital
Jan 2015 - Dec 2023 (8 years 11 months)
Analyzed denials and corrected billing to appropriate payors, prepared appeals and reconsideration letters, and validated coding accuracy to improve payment rates and compliance.
Education
Degrees, certifications, and relevant coursework
Meralco Foundation Institute
Certificate, Networking / IT
2006 - 2006
Completed a short technical course related to networking (Cisco) focused on practical skills for IT support.
Centro Escolar University
Bachelor of Science, Management Information System
2001 - 2005
Completed a Bachelor of Science in Management Information System focusing on information systems relevant to healthcare billing and claims processing.
Availability
Location
Authorized to work in
Job categories
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