Khalidah Idlana Dagbusan
Medical Doctor
Zamboanga City
Summary
Professional with solid expertise in managing and resolving claims. Skilled in analyzing data, negotiating settlements, and adhering to regulatory guidelines. Strong focus on team collaboration and delivering results. Reliable and adaptable with excellent communication and problem-solving skills.
Equipped with strong problem-solving abilities, willingness to learn, and excellent communication skills. Poised to contribute to team success and achieve positive results. Ready to tackle new challenges and advance organizational objectives with dedication and enthusiasm.
Overview
10
10
years of professional experience
4
4
Certifications
Work History
CLAIMS OFFICER
DNATA TRAVEL, INC.
02.2024 - Current
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Maintained confidentiality of patient finances, records, and health statuses.
- Verified client information by analyzing existing evidence on file.
- Processed and recorded new policies and claims.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Identified potential subrogation opportunities through careful examination of case details.
- Supported departmental goals by contributing ideas during team meetings aimed at refining processes within the organization.
- Continually updated knowledge on industry-specific regulations, ensuring compliance and maintaining a high standard of professionalism in interactions with clients.
- Managed caseload efficiently, prioritizing tasks based on urgency and importance to meet deadlines consistently.
- Reviewed contracts thoroughly to ensure proper coverage for various types of insurance policies held by clients.
MEDICAL CLAIMS OFFICER
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
09.2020 - 05.2024
- Prepared comprehensive reports for upper management detailing key findings from investigations into complex claim cases.
- Identified potential subrogation opportunities through careful examination of case details.
- Expedited claim resolution with prompt negotiation, evaluation, and settlement of claim amounts.
- Served as a mentor for junior staff members, offering guidance in navigating difficult situations encountered in the role.
- Continually updated knowledge on industry-specific regulations, ensuring compliance and maintaining a high standard of professionalism in interactions with clients.
- Reduced claims processing time by streamlining documentation and communication procedures.
- Negotiated fair settlements with policyholders while maintaining positive relationships between the company and clients involved in disputes.
- Improved interdepartmental communication to expedite claims processing and foster a collaborative work environment.
- Checked documentation for accuracy and validity on updated systems.
- Processed and recorded new policies and claims.
- Worked with claims adjusters and examiners to expedite processing in alignment with procedures.
- Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
- Communicated effectively with staff members of operations, finance and clinical departments.
- Monitored patient progress and adjusted treatments accordingly.
- Improved patient outcomes by implementing evidence-based medical practices and protocols.
- Improved patient outcomes and delivery of care through improved clinical quality processes.
- Mentored junior medical staff members through hands-on training sessions, reinforcing key concepts and guiding their professional growth.
- Reviewed complex cases alongside colleagues during peer consultations to develop consensus on appropriate courses of action for challenging scenarios.
JUNIOR CONSULTANT
METRO ILOILO HOSPITAL AND MEDICAL CENTER
01.2020 - 06.2024
- Assisted senior physicians and surgeons during assessments, examinations and surgical interventions.
- Enhanced patient satisfaction with thorough assessments, diagnoses, and treatment plans.
- Served as an approachable resource for patients'' families, addressing concerns and providing education on medical conditions and treatments.
- Advocated for patient-centered care within the healthcare facility by championing initiatives that cater to individual needs and preferences.
- Confirmed consistent and accurate medical recordkeeping practices.
- Monitored and evaluated treatment outcomes, adjusting strategies to optimize patient recovery.
- Improved patient satisfaction with personalized care and attention to detail.
- Participated in medical conferences and workshops, staying abreast of emerging trends in healthcare.
- Discussed medical histories with patients in effort to provide most effective medical advice.
- Communicated with patients, ensuring that medical information was kept private.
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Reviewed complex cases alongside colleagues during peer consultations to develop consensus on appropriate courses of action for challenging scenarios.
- Interpreted diagnostic test results for deviations from normal.
- Promoted a culture of safety within the healthcare facility, adhering to strict infection control measures and reporting potential hazards.
MEDICAL RESIDENT
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
01.2016 - 12.2020
- Trained and supervised medical students and residents engaged in special activities and procedures.
- Established partnerships with community organizations to improve access to preventive healthcare services and enhance overall population health.
- Conducted research studies to advance medical knowledge within the field, contributing to evidence-based practice guidelines.
- Ordered medical and laboratory supplies and equipment.
- Presented at conferences and workshops to share insights on innovative approaches in patient care management, fostering collaboration among peers within the industry.
- Entered and scanned patient history, current medical conditions and medications into novel EHR system.
- Kept informed on advancements in field to contribute to medical research programs.
- Optimized resource allocation, ensuring availability of necessary medical supplies and equipment.
- Managed emergency medical situations, providing immediate care and stabilizing patients for further treatment.
- Enhanced patient outcomes by implementing innovative treatment protocols.
- Implemented infection control measures, significantly reducing incidence of hospital-acquired infections.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
- Improved patient outcomes and delivery of care through improved clinical quality processes.
- Mentored junior medical staff members through hands-on training sessions, reinforcing key concepts and guiding their professional growth.
- Applied continuous process improvement strategies to enhance case management, programs and clinical management.
- Collaborated with interdisciplinary teams to optimize patient care and streamline communication.
- Implemented cost-saving measures while maintaining high-quality patient care, maximizing available resources for optimal results.
- Enhanced departmental performance by mentoring junior medical officers and sharing best practices.
- Served as an approachable resource for patients'' families, addressing concerns and providing education on medical conditions and treatments.
- Advocated for patient-centered care within the healthcare facility by championing initiatives that cater to individual needs and preferences.
- Communicated with patients, ensuring that medical information was kept private.
- Discussed medical histories with patients in effort to provide most effective medical advice.
- Participated in medical conferences and workshops, staying abreast of emerging trends in healthcare.
- Interpreted diagnostic test results for deviations from normal.
- Reviewed complex cases alongside colleagues during peer consultations to develop consensus on appropriate courses of action for challenging scenarios.
- Promoted a culture of safety within the healthcare facility, adhering to strict infection control measures and reporting potential hazards.
MEDICAL OFFICER III
OSPITAL NG PALAWAN
01.2020 - 05.2020
- Trained and supervised medical students and residents engaged in special activities and procedures.
- Established partnerships with community organizations to improve access to preventive healthcare services and enhance overall population health.
- Conducted research studies to advance medical knowledge within the field, contributing to evidence-based practice guidelines.
- Ordered medical and laboratory supplies and equipment.
- Presented at conferences and workshops to share insights on innovative approaches in patient care management, fostering collaboration among peers within the industry.
- Entered and scanned patient history, current medical conditions and medications into novel EHR system.
- Kept informed on advancements in field to contribute to medical research programs.
- Optimized resource allocation, ensuring availability of necessary medical supplies and equipment.
- Managed emergency medical situations, providing immediate care and stabilizing patients for further treatment.
- Enhanced patient outcomes by implementing innovative treatment protocols.
- Implemented infection control measures, significantly reducing incidence of hospital-acquired infections.
- Monitored and inspected staff processes to eliminate hazards posed for both residents and staff while ensuring continuous compliance with regulations.
- Improved patient outcomes and delivery of care through improved clinical quality processes.
- Mentored junior medical staff members through hands-on training sessions, reinforcing key concepts and guiding their professional growth.
- Applied continuous process improvement strategies to enhance case management, programs and clinical management.
- Collaborated with interdisciplinary teams to optimize patient care and streamline communication.
- Implemented cost-saving measures while maintaining high-quality patient care, maximizing available resources for optimal results.
- Enhanced departmental performance by mentoring junior medical officers and sharing best practices.
- Served as an approachable resource for patients'' families, addressing concerns and providing education on medical conditions and treatments.
- Advocated for patient-centered care within the healthcare facility by championing initiatives that cater to individual needs and preferences.
- Communicated with patients, ensuring that medical information was kept private.
- Discussed medical histories with patients in effort to provide most effective medical advice.
- Participated in medical conferences and workshops, staying abreast of emerging trends in healthcare.
- Interpreted diagnostic test results for deviations from normal.
- Reviewed complex cases alongside colleagues during peer consultations to develop consensus on appropriate courses of action for challenging scenarios.
- Promoted a culture of safety within the healthcare facility, adhering to strict infection control measures and reporting potential hazards.
MEDICAL OFFICER III
OSPITAL NG PALAWAN
06.2015 - 06.2015
- Created customized care plans, working with hospital staff and families to assess and meet individual needs.
- Collaborated with store manager to maintain daily operations.
- Improved patient outcomes by implementing evidence-based medical practices and protocols.
- Monitored patient progress and adjusted treatments accordingly.
- Assisted senior physicians and surgeons during assessments, examinations and surgical interventions.
- Enhanced patient satisfaction with thorough assessments, diagnoses, and treatment plans.
- Confirmed consistent and accurate medical recordkeeping practices.
- Monitored and evaluated treatment outcomes, adjusting strategies to optimize patient recovery.
- Improved patient satisfaction with personalized care and attention to detail.
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Optimized resource allocation, ensuring availability of necessary medical supplies and equipment.
- Managed emergency medical situations, providing immediate care and stabilizing patients for further treatment.
- Interpreted diagnostic test results for deviations from normal.
- Promoted a culture of safety within the healthcare facility, adhering to strict infection control measures and reporting potential hazards.
CLINICIAN
ISLAND CLINIC BORACAY
05.2015 - 05.2015
- Created customized care plans, working with hospital staff and families to assess and meet individual needs.
- Collaborated with store manager to maintain daily operations.
- Improved patient outcomes by implementing evidence-based medical practices and protocols.
- Monitored patient progress and adjusted treatments accordingly.
- Assisted senior physicians and surgeons during assessments, examinations and surgical interventions.
- Enhanced patient satisfaction with thorough assessments, diagnoses, and treatment plans.
- Confirmed consistent and accurate medical recordkeeping practices.
- Monitored and evaluated treatment outcomes, adjusting strategies to optimize patient recovery.
- Improved patient satisfaction with personalized care and attention to detail.
- Implemented successful healthcare program through professionalism, quality of care, medical teaching and patient satisfaction.
- Liaised with other healthcare professionals to develop comprehensive patient care plans and provide highest quality of care.
- Optimized resource allocation, ensuring availability of necessary medical supplies and equipment.
- Managed emergency medical situations, providing immediate care and stabilizing patients for further treatment.
- Interpreted diagnostic test results for deviations from normal.
- Promoted a culture of safety within the healthcare facility, adhering to strict infection control measures and reporting potential hazards.
MEDICAL RESEARCHER
Jubilent Health Ltd, Australia
08.2023 - 08.2024
- Improved research efficiency by streamlining data collection and analysis processes.
- Participated in international collaborations focused on addressing global health challenges.
- Established partnerships with external organizations to enhance resources and expertise available for research purposes.
- Advised on policy development based on evidence-based recommendations from research findings.
- Supervised data collection by core research staff.
- Prepared scholarly manuscripts and final study reports to communicate results of research
- Designed, constructed and implemented research proposals, protocols and procedures.
- Performed data analysis and interpretation of results from clinical trials and epidemiological studies.
Education
Master in Public Health - Public Health
Ateneo De Zamboanga University
Zamboanga City, Province Of Zamboanga Del Sur, Philippines04.2014
M.D. - Medicine
Ateneo De Zamboanga University-School of Medicine
Zamboanga City, Province Of Zamboanga Del Sur, Philippines 04.2001 -
Bachelor of Science - Nursing
Western Mindanao State University
Zamboanga City, Province Of Zamboanga Del Sur, Philippines 04.2001 -
Skills
Policy interpretation
Teamwork and collaboration
Microsoft office
Time management
Multitasking Abilities
Decision-making
Problem-solving aptitude
Adaptability
Case management
Analytical thinking
Certification
Advanced Cardiac Life Support Provider - Valid from November 2023-November 2025
References
- Rhea Mae A., Avanceña, Medical Monitor, West Visayas State University Medical Center
- Filipino L., Estacio, Medical Specialist, Camiguin General Hospital
- Roumilla B., Mendoza, Medical Specialist, West Visayas State University Medical Center
Affiliations
- Pediatric Hospitalist (Junior Consultant) - Metro Iloilo Hospital and Medical Center
- PhilHealth Accredited Health Provider
- Philippine Medical Association-Iloilo Medical Society Member, 2020-present
- West Visayas State University Medical Center Residents’ Alumni Association Member, 2016-present
- West Visayas State University Medical Center Pediatric Residents’ Alumni Association Member, 2020-present
- West Visayas State University Medical Center Employees’ Association Member 2016-present
- Ateneo de Zamboanga University Alumni Association, Member 2013-present
- Western Mindanao State University Alumni Association, 2008-present
IV. Research Works, Papers, Publications, and Thesis
- Compliance to the Repeat Expanded Newborn Screening Protocol Among Preterm Infants in the Visayas, Philippines - Primary Author, Unpublished, 2022
- The Profile of Diagnosed Leptospirosis Cases in Zamboanga City - Primary Author, Unpublished, 2014
V. Summary of CPD units in the last 4 years
- Year 2020: 79 Units Earned
- Year 2021: 84.5 Units Earned
- Year 2022: 78 Units Earned
- Year 2023: 62 Units Earned
- Year 2024: 82 Units Earned
Accomplishments
Finalist - National Case Report in the 2019 Philippine Pediatric Society National Convention
1st Place-Interhospital Case Report Presentation 2018 Philippine Pediatric Society Western Visayas
Additional Information
I like keeping myself active so I regularly run, go to the gym, and take hikes or long walks.
I also love to read and educate myself especially with things I am not familiar of.
I am a firm believer of holistic development - mind, body and soul.
Timeline
CLAIMS OFFICER
DNATA TRAVEL, INC.
02.2024 - Current
MEDICAL RESEARCHER
Jubilent Health Ltd, Australia
08.2023 - 08.2024
MEDICAL CLAIMS OFFICER
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
09.2020 - 05.2024
MEDICAL OFFICER III
OSPITAL NG PALAWAN
01.2020 - 05.2020
JUNIOR CONSULTANT
METRO ILOILO HOSPITAL AND MEDICAL CENTER
01.2020 - 06.2024
MEDICAL RESIDENT
WEST VISAYAS STATE UNIVERSITY MEDICAL CENTER
01.2016 - 12.2020
MEDICAL OFFICER III
OSPITAL NG PALAWAN
06.2015 - 06.2015
CLINICIAN
ISLAND CLINIC BORACAY
05.2015 - 05.2015
M.D. - Medicine
Ateneo De Zamboanga University-School of Medicine
04.2001 -
Bachelor of Science - Nursing
Western Mindanao State University
04.2001 -
Master in Public Health - Public Health
Ateneo De Zamboanga University