clarence tolentino

About Candidate

Location

Education

B
BS NURSING 2007
OUR LADY FATIMA UNIVERSITY

Work & Experience

R
RCM - IP/OP DRG MEDICAL CODER 01 NOVEMBER 2017 - 03 NOVEMBER 2025
HMS - AL GAHROUD PRIVATE HOSPITAL

 Supervising the IP/OP insurance coordinators  Processing/Sending Emergency,Elective IP, DayCase ( All Department )  Processing Revision IP, OP  RCM - Processiong Claims, ( Submission, Re-submission )  Knowledgeable with code, CPT code, ICD10, HCPCS  Coordinating with all Insurance company to ff up the approvals/request  Coordinating with the External Hospitals/Visiting Dr’s  Knowledgeable in DHPO, Eclaims, 3M’s, EMR and other system  Supervising All request and colleagues  Checking the Insurance Coverage and Non Covered  Always updated in Coding Guidelines

I
IP INSURANCE COORDINATOR 15 AUGUST 2015 - 04 OCTOBER 2017
UNIVERSAL HOSPITAL LLC

In charge on entering pre-authorization/approval for Out Patient and In Patient from different kind of insurance company  In charge on processing and completion of claim forms  In charge on sending approvals of Outpatient and Inpatient from the External Hospitals  Billing works of insurance companies with corresponding factors and deductible

I
INSURANCE COORDINATOR / Customer Service 23 JUNE 2013 - 11 AUGUST 2015
WELLCARE MEDICAL CENTER

In charge on processing and completion of claim forms  In charge on entering pre-authorization/approval for Out Patient and In Patient from different kind of insurance company  Billing works of insurance companies with corresponding factors and deductible  Coordinating to the hospitals about scheduling/booking of a operation to (Burjeel Hospital, Al Noor Hospital)  Checking the insurance card if its covered/expiry to any kind of procedure  Encode’s the patient information in a system  Informing the patient to their appointment through phone calls and SMS

P
PHARMACIST ASSISTANT / INSURANCE COORDINATOR JANUARY 2012 - APRIL 2013
MINA PHARMACY

 Assisting the Pharmacist if what medicine they want.  Checking the expiration of every single medicine/insurance card  Informing the pharmacist for the near expired medicine  Maintains orderliness and cleanliness within working area  Arranged the medicine in their proper shelve  Sending for approval through online ( PBM link-ADNIC , Open Jet-NAS) ( ECLAIMS )

Awards

M
MEDICAL CODER CPC SEPTEMBER 2024
MEDICAL CODER CPC