Previous Operation Expert from Healthcare Account
Iloilo
Experienced and reliable professional with strong communication and problem-solving skills, a solid work ethic, and a commitment to maintaining high standards. Seeking an opportunity to contribute effectively in a fast-paced work environment.
Carelon Global Solutions, full_time
Sep 2020 to Apr 2026
Handle inbound customer inquiries regarding eligibility, benefits, authorizations, claims, and appeals. Review and approve claims submitted by operations for prescreening and urgent review. Present and discuss concerns, verification requirements, and claim or benefit discrepancies during process improvement calls with onshore partners. Manage escalation calls, addressing complex customer concerns and coordinating appropriate resolutions. Monitor inventory levels and ensure all aging service requests are appropriately prioritized and addressed within established timelines.
PB Maritime Personnel, full_time
Sep 2019 to Feb 2020
Managed procurement, distribution, and inventory of office and consumable supplies. Negotiated with suppliers to secure competitive pricing. Reviewed supplier contracts and related documentation. Provided administrative support and assisted the Liaison Officer as needed.
Constellation Travels Inc., full_time
Sep 2016 to Sep 2019
Handled customer inquiries, concerns, and complaints through phone and email. Arranged travel accommodations for individuals, couples, and groups. Reviewed documents, performed data entry, and assisted clients with visa applications. Provided guidance to ensure accurate and smooth application processing.