Medical Claims Adjuster and Customer Service Representative
Philippines
I am an experienced Medical Claims Adjuster specializing in workers’ compensation claims, with a strong background in customer service and financial account support. I have managed claims from initial reporting through resolution, including reviewing medical records, coordinating with providers, authorizing treatments, and ensuring compliance with state guidelines. My role requires strong attention to detail, critical thinking, and the ability to make sound decisions while maintaining accuracy and timeliness. In addition to my claims experience, I bring solid customer service skills—handling inquiries, resolving concerns, and communicating clearly with clients, claimants, providers, and attorneys. I am highly organized, dependable, and comfortable working remotely with minimal supervision. What sets me apart is my ability to balance empathy with efficiency. I understand the importance of both compliance and compassionate communication. I bring value to clients by ensuring accurate claim handling, reducing delays, and providing professional, responsive support that builds trust and long-term relationships.
Accenture , full_time
May 2022 to Feb 2026
Responsible for managing workers’ compensation claims from intake through resolution. Reviews medical records, determines compensability, authorizes treatment, coordinates with providers and attorneys, and ensures compliance with state regulations. Communicates with claimants and employers, processes payments, and maintains accurate documentation to ensure timely and fair claim resolution.