Healthcare Customer Service Representative | Medical VA | Admin Staff
Mabalacat, Pampanga, Philippines
I’m a Healthcare BPO professional and Product Ready Trainer with strong expertise in U.S. healthcare insurance, Medicare, claims, and customer service operations. I combine frontline experience with training leadership — meaning I don’t just understand the process, I know how to improve it. Recognized as a Top Trainer for four consecutive months, I’ve successfully upskilled teams across multiple international sites, improving KPIs such as AHT, QA, and First Call Resolution. I specialize in turning complex healthcare policies into clear, member-friendly communication while maintaining strict HIPAA compliance. With a background in healthcare support, technical troubleshooting, and high-performing sales, I bring strong communication, data-driven coaching, and results-focused execution. What I deliver to clients: ✔ Improved team performance ✔ Higher first-call resolution ✔ Reduced repeat contacts ✔ Strong compliance and quality standards I don’t just support operations — I help optimize them.
Concentrix, full_time
Apr 2025 to Feb 2026
Responsibilities: Design, deliver, and update comprehensive training programs for new hires and tenured agents on claims adjudication, benefits, billing, and appointment coordination. Conduct Instructor-Led (ILT) and Virtual ILT (VILT) sessions with hands-on activities and real-life scenarios. Provide one-on-one coaching on active listening, call control, de-escalation, and empathy. Develop SOPs, reference guides, presentations, and performance dashboards. Track and analyze KPIs (AHT, QA, FCR) to refine training content and support agent growth. Collaborate with QA and Operations teams to address service gaps and optimize performance. Facilitate knowledge-sharing and ensure compliance with internal updates and protocols. Achievements: Recognized as Top Trainer for 4 consecutive months for outstanding coaching, leadership, and program effectiveness. Delivered virtual training across multiple sites: Malaysia, Baguio PH, UPL PH, India, and Egypt, successfully upskilling diverse teams. Streamlined training processes, improving agent readiness and performance.
Concentrix, full_time
Sep 2024 to Apr 2025
IResponsibilities: Serve as the first point of contact for members regarding healthcare coverage, claims, billing, and provider coordination. Explain complex benefits, EOCs, and EOBs to ensure member understanding. Investigate and resolve denied claims, balance bills, and coordination of benefits issues. Coordinate with claims, billing, and provider relations teams for escalated concerns. Document all interactions accurately in CRM systems, maintaining HIPAA compliance. Achievements: Reduced repeat calls and improved first-contact resolution. Maintained accurate support across multiple lines of business (MA, MAPD, DSNP, CSNP, Commercial, State Plans, PDP). Recognized for effective communication and teamwork.