Rhea Marasigan
Glen Oaks,NY
Summary
Dynamic Case Manager with proven expertise at Ventura Services, adept at resolving complex coverage disputes and enhancing patient care.
Professional with strong background in case management, prepared to make significant impact. Proven ability to collaborate with teams and adapt to changing needs. Skilled in client assessment, resource coordination, and crisis intervention. Reliable and results-focused, with commitment to achieving positive outcomes.
Overview
27
27
years of professional experience
Work History
Case Manager
Ventura Services
West Hempstead, NY
11.2018 - Current
- Act as the primary contact between physicians, patients, and insurance payers to resolve disputes and inquiries regarding coverage.
- Maintain accurate up-to-date records of authorizations, and prepare utilization reports on service performance. Ensure all procedures follow regulatory guidelines and company policies.
- Oversee three skilled nursing facilities to process, monitor, and obtain patients prior authorization, and long term authorization. Verify member eligibility, benefits, and coverage limitation for continued services.
HMO Coordinator / Medical Billing Assistant
Sentosa Care
01.2015 - 10.2018
- Process, monitor, and obtain prior authorizations for medical services, procedures, and hospital admission from managed care insurances.
- Assisted and resolving billing issues.
Administrative Coordinator / Medical Biller
Nuclear Medicine - Mount Sinai Medical Center
New York, NY
02.1999 - 07.2012
- Responsible for registration of patients and collecting co-payments.
- Knowledge of the methods and practices of administrative tasks.
- Perform the tasks of responding calls and scheduling patients appointments.
- Utilizes all available resources to obtain and enter insurance coverage information for services into patient's file.
- Medicaid Billing.
Education
High School Diploma -
Hillcrest High School
Jamaica, NYTimeline
Case Manager
Ventura Services
11.2018 - Current
HMO Coordinator / Medical Billing Assistant
Sentosa Care
01.2015 - 10.2018
Administrative Coordinator / Medical Biller
Nuclear Medicine - Mount Sinai Medical Center
02.1999 - 07.2012
High School Diploma -
Hillcrest High School