JY-KRIZZ A. GACUTAN, RN

2988 Balabac Street, Corner Jervois Street

Barangay Pinagkaisahan, Makati City

Mobile: +639055243698

E-mail: [email protected]

PROFESSIONAL EXPERIENCE

MediCard Philippines, Inc.

Sen Gil Puyat Ave., Makati City

Department: Medical Operations

Position: In-house Liaison Officer

September 2013 – December 2013

Position: Hospital/Field Liaison Officer (Senior)

Hospital Assignment:

St. Anthony Medical Center of Marikina, Marikina St. Vincent General Hospital,

Garcia General Hospital (December 2013 – June 2014)

Marikina Valley Medical Center (June 2014 – June 2016)

Job Description:

In-house Liaison Officer:
Provides assistance to Field Liaison Officer by handling requirements that can be settled through coordination with some units at the Head Office, and by answering telephone inquiries.
Handles telephone inquiries by providing corresponding assistance or solutions to the concern of the client-members.
Coordinates with the Billing/Collection department of accredited hospitals regarding the status and coverage of confined client-member/s at the Head office.
Hospital/ Field Liaison Officer
Responsible for the prompt catering of medical services to confined members, while ensuring the exactitude of benefits received. ( Average of 10-20 patients per day)
Checks emergency assistance response service’s logbook for confinements.
Accomplishes information sheet for a confined member, gathering demographics, and other necessary information for proper evaluation, such as History of present illness, Signs and symptoms, medications, procedure etc.
Ensures that a Letter of Authorization (LOA) is issued for a confined member and is received by the hospital personnel.
Visits and explains to a confined member the benefits and limitations of her/his coverage.
Coordinates with the Admitting, Billing and Accounting Section of the hospital for the assigned coverage of a confined member.
Assists patients during discharge and/or room transfer.
Mediates with the attending Physician about the concerns of the confined member.
Receives hospital bills of discharged patients as may be required.
Logs all bills and submits them to the claims and Utilization Department.
Acts as Internal Auditor for all accredited hospitals and Doctor in some other assigned area.
Delivers and ensures receipt of checks to MPI network.
Issues memoranda for new, renewal and non-renewal accounts.

Cognizant Technology Solutions Corporation

1820 Upper McKinley, Taguig City

December 2016 – May 2017

Program: HEDIS Support for a Northwest Health Insurance

Position: Research Associate/Clinical Abstractor

May 2017 – April 2018

Program: West Virginia Utilization Review

Position: Nurse Associate

April 2018 – Present

Program: Emblem health (Administrative Retrospective Utilization Review)

Position: Nurse Associate

Job Description:

Receives charts, hospital or clinic requests and records.
Gathers necessary information and do case summaries and nurses notes.
Preparing clinical history and summary for Physician review.
Strong knowledge with medical terminologies, procedure and medicines.
Has knowledge about ICD and CPT codes.
Working with confidentiality.
Assessing request for utilization for possible review.
Sending letters to the health insurance members, company, Doctors and/or Attorney.

EDUCATION

COLLEGE     Bachelor of Science in Nursing
Centro Escolar University

Makati City

2008-2012

SECONDARY    Pangasinan State University Laboratory Highschool
Bayambang, Pangasinan

2004-2008

PRIMARY    St. John Institute
Bautista, Pangasinan

1998 – 2000

Bautista Central School

Bautista, Pangasinan

2000 – 2004

HIGHLIGHTS OF QUALIFICATIONS

Dedicated with positive attitude
Honest, creative, resourceful, hardworking, and determined
Able to work independently or cooperatively as a part of a team to accomplish goals
Efficient  and can do work under pressure
Have a good written, oral and interpersonal communication skills
Languages spoken: English, Filipino, and basic conversational Korean
Computer literate (MS Word, PowerPoint, excel, internet)
Possesses nursing knowledge, skills, and attitude

PERSONAL BACKGROUND

Age            27 years old
Date of Birth        August 17, 1991
Place of Birth        Pasig City
Civil Status        Single
Citizenship        Filipino
Height            5’4”
Weight            122lbs.
Religion        Roman Catholic

TRAININGS AND SEMINARS ATTENDED

“Helping People with Depression”
December 15, 2010, Blessed Guisseppina Auditorium

Hospicio De San Jose, Manila

Administrator/Presentor: Sr. Maria Socorro Pilar G. Evidente, DC

“First Aid with Disaster Manageent and S.T.A.R.T. Triage”
April 26, 2011, Nursing Arts Laboratory

Centro Escolar University – Gil Puyat, Makati

1st Week of Integrated Seminar “Meeting the Challenge of the Future: Innovations and Updates on the Nursing Profession Towards national Progress and Global Competitiveness”
September 17, 2011, Students Activity Center

Centro Escolar University – Gil Puyat, Makati

“Updates in Leadership and Management”
Speaker: Dr. Marilou P. Furio, Vice President, Director for Nursing Service Division

Makati Medical Center

“Updates in Nursing Research”
Speaker: Prof. Rita C. Ramos, Assistant Professor,

University of the Philippines

“Oncology Nursing: Going Beyond the Extraordinary”
Speaker: Mrs. Cecilia P. Paje, Unit Manager,

Pioneers Cancer Center-Oncology and BMT Unit,

Makati Medical Center

Basic Life Support Training
Philippine Heart Association, Pasig City

November 8, 2012

Basic Korean Language
Korean Cultural Center of the Philippines

32nd Street Mancor Building, Taguig City

September 15, 2012- December 8, 2012

Intravenous Therapy Training
Rizal Medical Center, Pasig City

December 12, 13, and 15, 2012

AFILIATED/ORIENTED MEDICAL INSTITUTIONS:

Medical Center Paranaque
Ospital ng Muntinlupa
Ospital ng Makati
Las Pinas General Hospital
Alabang Medical Center
Sanctuary, Mandaluyong City
National Center for Mental Health
San Lazaro Hospital
Philippine Orthopedic Center
Elsie Gachez Village
Western Bicutan Health Center
North DaangHari Health Center
South Daang Hari Health Center

CHARACTER REFERENCES:

Available upon request

The above information given are true and correct

_______________________________

JY-KRIZZ A. GACUTAN, RN