Medical Receptionist/ Customer Service Representative
Camarines Sur, San Fernando, Philippines
Consistently achieved 95%+ first-call resolution rate, reducing repeat inquiries and improving provider satisfaction. · Recognized for maintaining average handling time below team benchmark, balancing efficiency with quality service. · Assisted in reducing claim denial rates by 10–15% through proactive investigation and resolution strategies. · Selected to handle priority escalations due to strong problem-solving and communication skills. · Contributed to team success by mentoring new representatives on system tools and best practices.
Concentrix , full_time
Sep 2022 to Jun 2025
Healthcare Customer Service Representative 2 years and 9 months Key Responsibilities · Managed high-volume inbound provider calls regarding benefits, eligibility, claims, appeals, reconsiderations, and prior authorizations. · Researched and resolved claim denials by identifying root causes and providing corrective solutions. · Escalated submitted documents via email to ensure timely resolution and compliance. · Utilized Avaya, MedCompass, Availity, Document Viewer, Rumba, and Microsoft Office for call handling, verification, and documentation. · Delivered accurate, empathetic support while maintaining efficiency and adherence to healthcare policies. Key Achievements · Consistently achieved 95%+ first-call resolution rate, reducing repeat inquiries and improving provider satisfaction. · Recognized for maintaining average handling time below team benchmark, balancing efficiency with quality service. · Assisted in reducing claim denial rates by 10–15% through proactive investigation and resolution strategies. · Selected to handle priority escalations due to strong problem-solving and communication skills. · Contributed to team success by mentoring new representatives on system tools and best practices. “During my tenure, I was recognized for consistently exceeding performance metrics, including high first-call resolution rates and efficient handling times. My proactive approach to denial resolution helped reduce provider frustrations and improved claim outcomes.” Awardees as quarterly rockstar and yearly as well.