Open to opportunities

Wilber Hernandez

@wilberhernandez

Message

I review medical claims, authorizations, and coverage decisions using clinical expertise and CPT/ICD-10 coding.

Dominican Republic

Message

What I'm looking for

I'm looking for a healthcare operations or medical claims role where I can apply clinical judgment, coding, authorization, documentation, and insurance coordination skills to support accurate decisions and continuity of care.

I'm a Medical Advisor at Bupa Global Latinoamérica, where I review medical claims for accuracy, coding, coverage, and supporting documentation using CPT and ICD-10 standards.

I coordinate with healthcare providers, physicians, and international insurance companies to authorize treatments, respond to inquiries, and maintain accurate medical records. My work centers on clinical guidelines, internal protocols, quality standards, and continuity of care.

As a medical doctor, I've provided adult and pediatric care in outpatient, emergency, and community settings at Hospiten and Servicio Nacional de Salud. I also bring high-volume documentation, verification, risk assessment, and customer support experience from underwriting, mortgage administration, and chat and email support roles.

Experience

Work history, roles, and key accomplishments

Current

Medical Advisor

Current

Bupa Global Latinoamérica

Jan 2026 - Present (8 months)

Analyze and review claims for data accuracy and proper coding using CPT and ICD-10 standards; assess medical cases, coverage, and supporting documentation. Coordinate with healthcare providers and physicians and authorize medical services and treatments based on clinical guidelines.

Medical Claims Review CPT ICD 10 Medical Authorization Clinical Documentation Electronic Medical Records Provider coordination HIPAA compliance

General Practitioner

Hospiten

Jan 2025 - Jan 2026 (1 year)

Provided comprehensive medical care to adult and pediatric patients in outpatient and emergency settings. Communicated with national and international health insurance providers to coordinate medical authorizations and verify coverage.

Medical Care Insurance Verification Medical Authorization Electronic Medical Records Patient Safety Quality Standards

Underwriting Analyst / Data Entry Specialist

Boost BPO

Jan 2024 - Jan 2025 (1 year)

Applied detailed document review, verification, accuracy control, and risk assessment skills in a high-volume underwriting environment. Maintained accurate documentation while evaluating applicant financial information.

Document Review Verification Accuracy Risk Assessment Data Entry

Medical Doctor

Servicio Nacional de Salud (SNS)

Jan 2023 - Jan 2024 (1 year)

Diagnosed and treated patients, prescribed treatments, and managed medical records in community healthcare settings. Maintained clinical documentation and conducted community health education programs.

Diagnosis Treatment Medical Records Clinical Documentation Health Education

Customer Care Advisor — Chat & Email Support

Teleperformance

Jan 2022 - Jan 2023 (1 year)

Provided written customer support through chat and email, documenting cases and resolving account, order, and delivery issues. Managed high-volume support queues while coordinating with customers and internal teams.

Customer Support Chat Email Support Case Documentation Queue Management

Mortgage Administration Clerk

Scotia GBS

Jan 2020 - Jan 2021 (1 year)

Reviewed mortgage files, bank statements, and loan documentation for accuracy and completeness and identified discrepancies. Maintained accurate file records and followed documentation and processing standards.

Mortgage Review Document Verification Accuracy File Management