1. FERRY HILL A. NOLASCO RN
Deira, Dubai, U.A.E.
Mobile no.: 055-3288622
Email add.: ferryhill.nolasco@yahoo.com
WORK EXPERIENCE:
Senior Claims Assessor
INAYAH TPA LLC
RAIS HASSAN SAADI GROUP
August 28, 2014-Present
Claims Processor
NEXTCARE HEALTH INSURANCE
Arab Gulf Health Services
July 31, 2011-July 31, 2014
Duties and Responsibility (Inayah TPA and Nextcare)
Medical Insurance Claim Processor
- manages insurance claims from patients in doctors' offices or at insurance
companies.
- analyze and process the insurance claim, checking it for validity.
-validates the information on all medical claims from patients seeking payment from
their insurance company.
-review claims thoroughly to ensure that there is no missing or incomplete
information.
- must keep meticulous records of claims and follow up on lapsed cases.
- decide whether an insurance company will pay a claim.
- review an insurance policy to determine what kind of coverage
- answered inquiries from providers on the subject of claim, eligibility, covered
benefits and approval status issues.
Medical Insurance Authorization
-ensure payment for services by verifying benefits with insurance provider.
-obtain, review and input insurance authorization and referrals prior to patient
services.
-monitor and track patient authorizations, informing supervisor of any expired dates.

2. -interview and assist patients with authorization documents, as appropriate.
-maintain appropriate logs or reports according to professional, state and federal
requirements.
Medical Claims Adjudicator
-look through clients’ insurance files to determine the type of policies that they are
covered under
-verify type and tenure of policies from insurance companies by indulging in
conversation with representatives over the telephone, through email and in person
-determine clients’ eligibility for medical insurance payouts by coordinating with
hospitals, police staff and other people involved in accident, illness and
hospitalization
-review claim forms in detail to ensure that all provided information is complete and
accurate
-provide clients with information on incomplete form entries and assist them in
locating avenues to obtain them
-identify process improvements and offer solutions to claim denials and
resubmissions
-assist clients by resubmitting their claims for second approvals and communicate
with insurance companies to provide them with heads ups
-enter information in the company’s internal database for future or further reference
-prepare materials for claims audits and provide assistance to auditors during the
procedure
-perform follow-up services to ensure that all unpaid and selective denied claims are
paid in an accurate and timely fashion
-obtain necessary documentation from various individuals and groups to provide
credence to filed claims
Medical Reimbursement Specialists
-review insurance claims in the billing department and ensure that clients or
customers receive accurate reimbursements for their claims.
-determine the method of payment for patients.
-managing financial and medical records.
-transcribe medical reports, greet new patients and schedule appointments.
-investigates patient's insurance benefits. - Identifies network providers, provider
restrictions, co-pays as needed.
-secures documents requirements for prior authorization and medical review process
and documents activities appropriately in progress notes.
-pursue product coverage for patients in accordance with the payor's authorization
requirements within the department's established performance criteria.
-create written communication to customers regarding reimbursement status.
-maintains payor profiles by recording payor specific data promptly into the system.
-consults with team members on an as needed basis.
-collects and enters data for distributor referral cases.
-demonstrates effective problem solving and excellent customer service.
-works closely with the project managers on project invoicing and revenue
recognition.

3. -preparation of journal entries, reconciliation and maintenance of general ledger
accounts, preparation of specified accounting records for month end closing, review
of project expense reports and analysis.
-review final invoices for all billable projects, including all applicable backup for
approval.
-make collection calls, conduct account research and analysis, and interact with
customers to resolve outstanding issues.
-prepare balance sheet account reconcilements.
-monthly reporting of invoicing totals/aging totals/cash receipts/invoice
adjustments/rebates
Medical Claim Resubmission Specialist
-take all the claims submission from insurance department every month.
-check and download the XML Remittance Advice from HAAD and follow up for
any missing remittance advice.
-analyzing the rejection from the XML remittance Advice.
-sort out the rejection as per denial reason.
-sending the rejected claims for the respected doctors for justifying the claims if
necessary and follow up with the doctors within the specified time.
-preparing rejected claims for resubmission.
-submitted the claims with proper codes and format to insurance companies.
-make sure that the final rejection is at its minimal level.
-should meet the resubmission productivity targets within the stipulated time for all
insurance companies.
STAFF NURSE
St. James Hospital
Pantay Daya, Vigan City Ilocos Sur
December 2008 to June 16, 2009
Scope of Work:
• Medical ward: giving medications, checking vital sign
• Surgical ward: wound dressing, assist physician in cleaning wounds, and
promote proper hygiene
• Emergency room: rendering fast, reliable and immediate care to patients
• ICU: careful and accurate care for patient’s faster recovery
• OB/Gyne ward: IV insertion, promoting patients comfort fast and accurate
delivery by giving assistance to doctors to lessen the pain in delivery as well as
to post operation patients who underwent cesarean section.
VOLUNTEER NURSE
Gabriela Silang General Hospital
Tamag, Vigan City Ilocos Sur
July 16, 2009 to January 15, 2010
Scope of Work:
• Medical Ward: observing good collaboration with fellow nurses in giving
health care
• Surgical Ward: assist patient to perform range of motion exercises for faster
recovery

4. • Emergency Room: getting patients baseline data to identify proper treatment
• ICU: checking vital signs from time to time for daily record to evaluate
progress of the patient
• NICU: rendering tender loving care to newborn and holistic care to seriously
ill babies
STAFF NURSE
Valera Medical Hospital
Rizal St., Zone 7, Bangued, Abra
February 1, 2010 to April 30, 2011
Scope of Work:
• Medical Ward: proper health teachings to discharged patients to promote
good recovery.
• Surgical Ward: deep breathing exercise and good nursing care as per doctors
order.
• Emergency Room: experienced several types of emergency situation and how
to lessen anxiety to patients and watchers.
• ICU: Individual nursing care for every case encountered.
• Nursery: showing the importance of breastfeeding and mother child
relationship.
OBJECTIVE:
To contribute in bringing excellent services to the extent of my ability and
dedication to work.
MAJOR STRENGTHS
• Ability to mingle and have good working relationship with other persons.
• Hardworking and very much devoted to work.
• Honest, loyal and wise.
• Willing to learn.
• Competitive and well disciplined.
• Has a wide background in nursing people.
(Graduated March 2008 in the course Bachelor of Science in Nursing
and passed the Nursing Licensure Examination the same year and
attended several seminars about nursing).
EDUCATIONAL ATTAINMENT:
TERTIARY : Bachelor of Science in Nursing (Board Passer)
University of Northern Philippines
Vigan City, Ilocos Sur, Philippines
2004 – 2008

5. PERSONAL INFORMATION:
Birth Date : July 03, 1987
Place of Birth : Rome, Italy
Age : 29 yrs. Old
Gender : Male
Status : Married
Nationality : Filipino
Religion : Christian
Visa Status : Employed
I do hereby certify that the statement I have made in this application for
employment are true and correct that any misinterpretation, falsification of willful
commission here in be sufficient cause for refusal or employment or summary for
company’s service of employed.
FERRY HILL A.
NOLASCO
Applicant

6. PERSONAL INFORMATION:
Birth Date : July 03, 1987
Place of Birth : Rome, Italy
Age : 29 yrs. Old
Gender : Male
Status : Married
Nationality : Filipino
Religion : Christian
Visa Status : Employed
I do hereby certify that the statement I have made in this application for
employment are true and correct that any misinterpretation, falsification of willful
commission here in be sufficient cause for refusal or employment or summary for
company’s service of employed.
FERRY HILL A.
NOLASCO
Applicant