Lily May Loreto H. Veal
Zachary,LA
Summary
Work objectives:
Be a part of a reputable company with a wholistic mission to achieve, provide and sustain a healthy environment for all stakeholders thru a dynamic, continuous, and extensive research and a seamless customer experience.
Be empowered and learn the best practices of the industry by exploring new processes, tools, and people.
Share a positive, friendly, driven, focused, empathic, critical-thinking, attitude and work ethics that will deliver the best acceptable outcome in a complex work environment.
Pursue a mature and responsible job with an opportunity for professional challenges and growth.
Overview
29
29
years of professional experience
Work History
Medical Technologist
National Kidney And Transplant Institute
10.1993 - 09.1994
- https://nkti.gov.ph
- To share skills, talent, and vast knowledge as I've been trained in various sections in clinical laboratory (hospital set up)
- Phlebotomy
- Proper collection, handling, processing, testing and analyses of various specimen
- Specimen processing in clinical chemistry, hematology, clinical microscopy, histology, blood bank and serology, microbiology and parasitology, virology, and molecular biology
- Analyzed laboratory findings to check accuracy of results
- Followed laboratory protocols for specimen processing, analysis, and results reporting
- Maintained required laboratory supplies inventory, and verified viability of supplies prior to use
- Trained and oriented new medical technologists to perform and interpret tests
Clinician / Medical Doctor
Hospitals
08.2000 - 06.2005
- https://jrrmmc.gov.ph
- https://www.unihealthchristthekinghospital.com
- Attends to patients in emergency room for triaging, initial diagnosis proper referral and co- management
- Provides immediate care and treatment on patients in emergency room
- Provides patient's orders to nurses based on patient's status and assessment
- Orders laboratory and diagnostics tests for patients in ER and medical/ surgical wards
- Interprets and endorses patient's laboratory test results
- Endorses to specialists (and other managing physicians) regarding patient's condition, status, and diagnostic results
- Provides pre-operative care for patients with elective and emergency surgery
- Provides anesthesia to patients under surgical treatment
- Provides post operative care and recovery orders after patient's surgical procedure
- Ensures that patients are endorsed and properly transferred to their specific rooms after recovery period
- Provides daily assessment and rounds (and possible referrals) on post operative patients and other medical patients endorsed by medical team
- Provides discharge orders to patients and inform relatives of such and schedule follow up visit
- Attends, presents cases, and participate in monthly and quarterly patient management forum
- Attends to society conferences and meetings
- Attends to local and international conventions and trainings
- Educated patients and families on benefits of healthy diet and adequate exercise.
- Educated patients and families on benefits of healthy diet and adequate exercise
- Maintained confidentiality of patient information according to federal guidelines and regulations
- Teamed with other physicians, specialists, and health care providers to provide well-rounded care for complex cases
- Interviewed patients concerning physical complaints, discussed symptoms, asked questions, and suggested treatment options
- Provided emergent medical care and treatment for life-threatening injuries and illnesses
- Met with patients to discuss medical histories and current complaints
- Reviewed patient allergies, problems, medications, and immunization statuses
- Diagnosed and treated patients suffering from chronic conditions
- Coordinated and integrated health care resources for community-based programs
- Evaluated previously prescribed interventions for successes or failures and adjusted strategies
- Conducted research and stayed current with medical advancements, contributing to growth of medical knowledge
Assistant Vice President
Maxicare Healthcare Corporation
07.2005 - 08.2010
- https://www.maxicare.com.ph/
- Head of Claims and Medical Providers Relation
- Manages team of claims processors and supervisors (in -house and outsourced) around 150 people
- Provides training on proper claims adjudication for out-patient and in- patient claims from various medical providers (clinics and hospitals) using ICD code 10
- Ensures that adjudicated claims are processed accurately based on processor's approved limit
- Reviews and approves all claims under own approval limit and endorses exceptional cases to co – approvers (CFO and CEO)
- Ensures that processed claims are paid on time based on service level agreement terms
- Ensures that clinics and hospital's payment and service bonds are fully paid and replenished to avoid non acceptance of card users
- Accredits physicians (of all specialties), clinics and hospitals nationwide
- Assess and recommends set up of branch processors based on claims volume
- Provides support on simple and complex issues to external clients (HMO card users and medical providers)
- Participates in the formulation and review of existing and new policies and guidelines
- Ensures that the department manpower and workload is commensurate
- Provides staff coaching monthly and bi-annual basis
- Collaborates with other teams (Marketing, Distribution, Actuarial, Finance, IT, Customer Service, and HR) to achieve a smooth working environment
- Gives reports and updates to management and other stake holders on weekly and monthly meetings
- Attends to society conferences and meetings
- Attends to local and various society's conventions and trainings, Medical Services, Claims and Company Physician ( Life, ) https://www.prulifeuk.com.ph/en/
- Process and deliver interrupted work output thru face to face and remote process
- Continued to work even in US
- Provides training on different claims based on product type and policies
- Ensures that adjudicated claims are reviewed and processed equitably and accurately based on processor's approved limit
- Reviews and approves all claims under own approval limit and endorses exceptional cases to co – approvers (CFO and CEO)
- Ensures that processed claims are paid on time based on service level agreement terms
- Attends to life insurance meeting on complex claims matters and deliberation
- Accredits physicians and clinics nationwide for new business and after- sales client's medical requirements
- Ensures that medical providers (physician and clinics) are paid accurately and on time
- Reviews and updates medical service contract and ensure that such are updated
- Reviews and provides underwriting assessment based on medical and non-medical declaration of life insured/ policy owners
- Recommends critical steps in assessment of new business cases and lapse policies
- Provides support on simple and complex issues to external clients (policy owners, agents, medical providers, and internal teams)
- Participates in formulation and review of existing and new policies, products, and guidelines
- Ensures that department manpower and workload is commensurate
- Provides monthly staff coaching and reviews staff performance during midyear and year end appraisal
- Collaborates with other teams (Marketing, Distribution, Brand Communication, Actuarial, Finance, Legal and Compliance, Information and Technology, Customer Service, Transformation team and Human Relations) to achieve smooth and friction-less working environment
- Gives reports and updates to management and other stake holders
- Practice new works of working thru agile process
- Attends to employees and their dependents' medical concerns (thru face to face and virtual consultation)
- Participates in various company projects by creating new application platform
- Attends to various society conferences and meetings
- Attends to various insurance company conventions and trainings
- Attended weekly meetings and special sessions of Leadership and Executive Leadership Teams and contributed to major administrative initiatives, policies and decisions
- Communicated with leadership teams to assist with administrative initiatives and decisions and attended weekly meetings to support policy changes
- Reviewed incoming correspondence and drafted appropriate responses for CEO and other high-level stakeholders
Assistant Vice President for Medical Services
PRULIFE Of UK
10.2010 - 08.2022
- https://www.prulifeuk.com.ph/en
- Process and deliver interrupted work output thru face to face and remote process. Continued to work even in US
- Provides training on different claims based on product type and policies
- Ensures that adjudicated claims are reviewed and processed equitably and accurately based on processor's approved limit
- Reviews and approves all claims under own approval limit and endorses exceptional cases to co – approvers (CFO and CEO)
- Ensures that processed claims are paid on time based on service level agreement terms
- Attends to life insurance meeting on complex claims matters and deliberation
- Accredits physicians and clinics nationwide for new business and after- sales client's medical requirements
- Ensures that medical providers (physician and clinics) are paid accurately and on time
- Reviews and updates medical service contract and ensure that such are updated
- Reviews and provides underwriting assessment based on medical and non-medical declaration of the life insured/ policy owners
- Recommends critical steps in the assessment of new business cases and lapse policies
- Provides support on simple and complex issues to external clients (policy owners, agents, medical providers, and internal teams)
- Participates in the formulation and review of existing and new policies, products, and guidelines
- Ensures that the department manpower and workload is commensurate
- Provides monthly staff coaching and reviews staff performance during midyear and year end appraisal
- Collaborates with other teams (Marketing, Distribution, Brand Communication, Actuarial, Finance, Legal and Compliance, Information and Technology, Customer Service, Transformation team and Human Relations) to achieve a smooth and friction-less working environment
- Gives reports and updates to management and other stake holders
- Practice new works of working thru agile process
- Attends to employees and their dependents' medical concerns (thru face to face and virtual consultation)
- Participates in various company projects by creating new application platform
- Attends to various society conferences and meetings
- Attends to various insurance company conventions and trainings
Education
Bachelor of Science - Nursing
Lanting College of Nursing
Quezon City06.2006
M.D. - Medicine
Manila Central University
Manila06.1999
Bachelor of Science - Medical Technology
Centro Escolar University
Manila06.1993
Bachelor of Science - Genetic Microbiology
University of Sto. Tomas
Manila06.1995
Skills
- Hospital and Laboratory works ( For In-Patient and Out Patient)
- Patient Data Processing in Hospitals
- Adjudication of simple and complex claims cases (for Health and Life Insurance Companies)
- Comprehends corporate and standard regulatory contracts
- Medical underwriting and review of insurance application ( simple and complex)
- Can work remotely
- People & management friendly
- Driven for excellent output
- Works with minimal supervision
- Open to learn new knowledge
- Able to share working experiences
- Tolerant and resilient to extreme life challenges and changes
Affiliations
Passed NURSING BOARD EXAMS (California)
Philippine Association of Medical Technologist (PAMet)
Las Pinas City Medical Society (LPCMS) Philippine Medical Association (PMA)
Philippine Society of Insurance Medicine (PSIM),
Philippine Society of Occupational Medicine (PSOM)
Life Insurance Claims Association of the Philippines (LICAP)
Languages
English
Full Professional
Excellent in gardening and sports
I have grown microgreens and other specialty greens (e.g. Arugula, Swisschard and Bokchoy)
My favorite sports are tennis, badminton and swimming.
Timeline
Assistant Vice President for Medical Services
PRULIFE Of UK
10.2010 - 08.2022
Assistant Vice President
Maxicare Healthcare Corporation
07.2005 - 08.2010
Clinician / Medical Doctor
Hospitals
08.2000 - 06.2005
Medical Technologist
National Kidney And Transplant Institute
10.1993 - 09.1994
Bachelor of Science - Nursing
Lanting College of Nursing
M.D. - Medicine
Manila Central University
Bachelor of Science - Medical Technology
Centro Escolar University
Bachelor of Science - Genetic Microbiology
University of Sto. Tomas
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