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Professional Summary
Results-oriented specialist with 2+ years of experience in healthcare operations, specializing in ABA billing integrity and multi-state Medicaid compliance. Expert in navigating complex payor manuals, auditing CPT codes (97151–97158), and securing revenue through meticulous fee schedule research and denial appeals.
Proven track record managing master compliance logs — OIG, SAM.gov, and BCBA/RBT registries — and building automated operational workflows that protect a clinical agency's financial health.
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Key Skills
Regulatory Compliance
- OIG / SAM.gov exclusion screening
- Medicaid & MCO manual interpretation
- BCBA / RBT supervision mandates
Billing Knowledge
- CPT codes 97151–97158 (ABA therapy)
- Modifier application
- Fee schedule research
Claims Management
- Insurance appeals
- Denial root-cause analysis
- Payor portal management
Platforms
- Availity, CentralReach / CRDB
- BACB certificant registry
- Medicaid provider portals
CRM & Automation
- GoHighLevel, Zapier, HubSpot
- Workiz, Monday.com, WellSky
- Retool, Rippling
AI & Voice Integration
- Claude, ChatGPT, Gemini
- ElevenLabs, Voiceflow
Funnel & SaaS Setup
- Funnel building, SaaS setup
- Online business management
- Team leadership
Support & Communication
- Customer support, conflict resolution
- Slack, Zoom, Intercom, WhatsApp, Teams
- Canva, Adobe Suite, CapCut
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Professional Experience
Jul 2025 — Presentcurrent
Compliance Specialist — Special Operations
AEQ · Behavioral Health Agency
- Direct research and maintenance of payor fee schedules and modifier listings, notifying billing and revenue-integrity teams of rate updates.
- Conduct telehealth-eligibility audits on CPT codes 97151–97158, identifying payor mandates for telehealth vs. in-person delivery to prevent denials.
- Run monthly exclusion screenings across OIG, SAM.gov, and state lists; verify BCBA and RBT certifications in real time.
- Draft insurance appeals with word-for-word payor manual citations and screenshots to overturn payment denials.
- Built a standardized Payor Compliance Template and a centralized filing system linking contracts, MCO statuses, and facility requirements.
- Serve as primary liaison between Contracting, Credentialing, and Billing to resolve licensing and EFT/payment setup issues.
- Evaluated TPA and rented-network arrangements — including Luminare Health, Moda Health, and Aetna — to identify primary contracted networks.
- Managed multi-state payer enrollment linking billing entities and TINs/EINs for Anthem/Carelon (OH), Horizon BCBS (NJ), BCBSRI, Ambetter of Oklahoma, BCBS OK, and Managed Health Network (OR).
Jul 2025 — Presentcurrent
Chief Operations Officer & Industrial Partner
Tita Neng's · Davao City, Philippines
- Serve as COO and industrial partner of a food manufacturing business specializing in peanut-based products.
- Oversee production and team performance during weekend site visits; act as production consultant and coach for cooks.
- Lead marketing and sales initiatives, including consignments and retail partnerships.
- Supervise a two-person team, guiding costing, sales monitoring, and financial reporting.
Oct 2024 — Jul 2025
Administrative Support Specialist
Pencil Spaces · Remote
- Delivered support via phone, email, and conferencing platforms, achieving 95% customer satisfaction.
- Provided technical troubleshooting for Google Workspace and IT systems, reducing downtime by 20%.
- Designed marketing and presentation materials in Canva/Photoshop to support business development.
- Streamlined client documentation processes, improving response time on escalations.
Feb 2022 — 2024
Chief Assistant Director / Team Leader / Funnel Builder / Automation Specialist
JCMR High Level Experts · Philippines (International Clients)
- Led 10+ international client projects — SaaS setups, funnels, and automations — increasing conversions by 25%.
- Oversaw 50+ client subaccounts, ensuring smooth CRM operations and proactive troubleshooting.
- Deployed voice AI and conversational chatbots, reducing manual inquiries by 40%.
- Trained and managed team members, improving productivity by 30% through SOP-based onboarding.
Aug 2019 — 2020
Customer Support Specialist
VXI Global Solutions · Philippines (U.S. Clients)
- Supported U.S. customers with billing, account, and technical issues, maintaining a 90%+ resolution rate.
- Handled high-volume inbound queries, consistently surpassing KPIs in response time and CSAT.
- Identified recurring issues and worked with product teams to improve service delivery.
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Certifications
OBM
Certified Online Business Manager
GHL
HighLevel CRM Specialist
CSP
Customer Service Professional
HIPAA
HIPAA Compliance Training
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Selected Projects
+20%
Sales Funnel Development
Built a high-converting funnel for an international client.
−30%
Email Automation
Cut manual tasks with automated follow-up sequences.
30+
SaaS & Subaccount Management
Managed subaccounts with seamless client onboarding.
24/7
AI Chatbot Deployment
Implemented ChatGPT-powered support bots.
0 min
Wix → GoHighLevel Migration
Executed a full eCommerce migration with minimal downtime.
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Education & Languages
Education
Mechanical Engineering
University of Mindanao · Undergraduate
Languages
English
Fluent
Filipino
Native