Michael Pineda

Interfaced with clients to ensure satisfaction and reviewed overall processes on charges and collections for optimal reimbursement. Handled complex client questions and issues, resolved team problems, and compiled various reports for trend analysis and client recommendations.

Monitored charges, accounts receivables, denials, and lost visits, taking corrective actions to resolve open accounts. Coordinated with other departments on issues affecting collections and oversaw Team Leaders' performance.

Supervised a team of 20 claims processors, delegating workload equitably and monitoring staff performance. Responsible for quality assurance of processed claims and reviewing rejected claims.

Monitored and assigned daily workload batches to team members and was responsible for end-of-day closing and claim submission. Reviewed staff performance, prepared team quotas, and ensured quality assurance of processed claims.

Ensured the preparation of accurate and compliant medical insurance claims for timely submission and addressed claim denials by coordinating resubmissions and crafting appeal letters. Developed proactive strategies to minimize claim denials and stayed updated on the latest billing requirements and regulations.

Studied Psychology at the University of the Philippines Diliman. Focused on core psychological principles and research methodologies.

Pursued Clinical Psychology at Polytechnic University of the Philippines. Gained foundational knowledge in clinical practices and psychological theories.