Supporting clinics
from anywhere.
I am Nikkimark Samoya, a Medical VA with 9 years at Optum (UnitedHealth Group) — 5 of those inside UMR Insurance handling eligibility, benefits, prior authorization, and claims across major US health plans. Now working directly in clinic workflows and ready to support your practice remotely.
About Me
9 years on the payer side. Now working for yours.
I spent 5 years inside UMR Insurance — one of the largest third-party administrators in the US — processing eligibility checks, benefits verification, prior authorization, and claims resolution for employer-sponsored health plans every day. I then continued at Optum in a WFM/RTA role supporting Specialty Pharmacy, Optum Financial, and OGA Clinicals lines. That means I already know how payers think, what triggers denials, and how to navigate the portals your billing staff calls about.
I have since completed a live internship at Phoenix Med Health, working inside Tebra practice management, Availity, Noridian, and UnitedHealthcare portals on real patient cases. I hold current HIPAA certification and completed an in-depth RCM and Medical VA Masterclass in early 2026.
I'm available remotely for US-based practices, focused on prior authorization, insurance verification, and billing support.
Healthcare BPO Experience
Over 9 years across insurance operations — eligibility, claims, prior authorization, and benefit verification.
Medical Billing Internship
Hands-on training at Phoenix Med Health covering billing, eligibility, denial management, and payer portals.
Payer & EMR/EHR Familiarity
Availity, Noridian, UnitedHealthcare portals, plus Tebra practice management.
HIPAA-Compliant Practice
Trained in HIPAA and cybersecurity protocols — handling PHI with full compliance.
Why a Medical VA from the Philippines?
Filipino Medical VAs are trusted by US clinics and private practices for a reason: strong English communication, a culture of service, and a healthcare system that mirrors US insurance workflows. The Philippines produces one of the largest pools of healthcare-trained professionals in the world — and the time zone overlap with US hours makes real-time collaboration straightforward. For a clinic looking to reduce overhead without sacrificing quality, a Philippine-based Medical VA is one of the most cost-effective and reliable choices available.
What I Bring
Skills from Real Experience
Services
What I Can Do for Your Practice
Tasks I can take off your team's plate — handled remotely, accurately, and in full compliance with HIPAA.
Insurance Eligibility Verification
Confirm patient coverage, plan type, active status, and coverage dates before appointments — reducing claim rejections before they happen.
Benefit Verification
Review and communicate copays, deductibles, coverage limits, and exclusions so providers and patients know what to expect.
Claims Inquiry & Follow-up
Check claim status, payment details, and pending issues across payer portals — keeping your revenue cycle moving.
Prior Authorization
Submit, track, and follow up on PA requests across commercial payers and Medicaid plans.
Denial Management
Investigate denials, identify root causes, and coordinate corrected claims or appeals to recover revenue.
HIPAA-Compliant Documentation
Maintain accurate records and call notes in compliance with HIPAA standards — keeping your practice protected and audit-ready.
Experience
A 9-year path through US healthcare
April 2026 (Ongoing)
Medical Billing & RCM Intern
Phoenix Med Health · Arizona (Remote) · via RevConnex
Hands-on internship covering full revenue cycle workflows.
- Billing, eligibility, and denial management
- Payer portals: Availity, Noridian, UnitedHealthcare
- EMR / PM systems: Tebra
- Managed Care Organizations & state-specific Medicaid plans
Dec 2021 – Jan 2026
Workforce Management / Real-Time Adherence
Optum (UnitedHealth Group) · Cebu
Cross-functional WFM/RTA role supporting three healthcare lines: Specialty Pharmacy (BriovaRx), Optum Financial, and OGA Clinicals.
- Coordinated inpatient/outpatient prior authorizations for OGA Clinicals — working directly with providers and escalating complex cases to medical directors
- Supported BriovaRx Specialty Pharmacy: PA coordination, medication access, and patient support for complex/chronic conditions
- Managed multi-channel queues (calls, emails, casework) across Specialty Pharmacy, Optum Financial, and OGA Clinicals lines
- Tracked SLA compliance, AHT, and FCR; submitted end-of-day adherence and productivity reports
Oct 2016 – Dec 2021
Customer Service Representative
UMR Insurance (UnitedHealthcare TPA) — BPO
UMR is a UnitedHealthcare subsidiary and one of the largest third-party administrators managing commercial health insurance for employer-sponsored plans.
- Eligibility checks — member active status, coverage dates, plan type
- Benefit verification — plan details, copays, deductibles, exclusions
- Claims inquiry — status, payment details, denials, pending issues
- Claims resolution — escalations, adjustments, internal coordination
- Prior authorization — plan requirements and dashboard approval status
- Documentation in CallTrak & HIPAA compliance
Credentials
Education & Certifications
Education
Bachelor of Science in Biology
MSU – Iligan Institute of Technology
Iligan, PhilippinesCertifications
HIPAA Compliance & Awareness Training
RevConnex Solutions — RCM Academy
RCM & Medical VA Masterclass
RevConnex Solutions — RCM Academy
Tebra Practice Management Modules
Tebra University
Welcome to Tebra
Tebra University