Jean Paulin
Credentialing Team Lead at PMAXGlobal- Claim this Profile
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English Full professional proficiency
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Tagalog Professional working proficiency
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Cebuano Native or bilingual proficiency
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Ilonggo Native or bilingual proficiency
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Spanish Elementary proficiency
Topline Score
Bio
Abigail Luna, CPCS
Jean and I have worked remotely since 2020 and she is a pleasure to work with. I find that she is very passionate and dedicated to her work, very friendly, respectful, professional and knowledgeable.
Karen Grace Raquiza
Miss Jean was my mentor when I started in the healthcare industry. She has superb leadership skills and really know how to handle her team. She is very passionate with her work and always finds a way in achieving her goals. I am blessed and honored to have worked with her.
Madette Villasencio
It has always been my honor to be working with Jean for 4 years now and in that time I have known her to be a very flexible and hardworking supervisor and colleague. She has built a strong reputation as someone with diligence. She is someone who gets things done in no time.I have no hesitation(s) in recommending her and know that she will always give of her best in any endeavor..
Abigail Luna, CPCS
Jean and I have worked remotely since 2020 and she is a pleasure to work with. I find that she is very passionate and dedicated to her work, very friendly, respectful, professional and knowledgeable.
Karen Grace Raquiza
Miss Jean was my mentor when I started in the healthcare industry. She has superb leadership skills and really know how to handle her team. She is very passionate with her work and always finds a way in achieving her goals. I am blessed and honored to have worked with her.
Madette Villasencio
It has always been my honor to be working with Jean for 4 years now and in that time I have known her to be a very flexible and hardworking supervisor and colleague. She has built a strong reputation as someone with diligence. She is someone who gets things done in no time.I have no hesitation(s) in recommending her and know that she will always give of her best in any endeavor..
Abigail Luna, CPCS
Jean and I have worked remotely since 2020 and she is a pleasure to work with. I find that she is very passionate and dedicated to her work, very friendly, respectful, professional and knowledgeable.
Karen Grace Raquiza
Miss Jean was my mentor when I started in the healthcare industry. She has superb leadership skills and really know how to handle her team. She is very passionate with her work and always finds a way in achieving her goals. I am blessed and honored to have worked with her.
Madette Villasencio
It has always been my honor to be working with Jean for 4 years now and in that time I have known her to be a very flexible and hardworking supervisor and colleague. She has built a strong reputation as someone with diligence. She is someone who gets things done in no time.I have no hesitation(s) in recommending her and know that she will always give of her best in any endeavor..
Abigail Luna, CPCS
Jean and I have worked remotely since 2020 and she is a pleasure to work with. I find that she is very passionate and dedicated to her work, very friendly, respectful, professional and knowledgeable.
Karen Grace Raquiza
Miss Jean was my mentor when I started in the healthcare industry. She has superb leadership skills and really know how to handle her team. She is very passionate with her work and always finds a way in achieving her goals. I am blessed and honored to have worked with her.
Madette Villasencio
It has always been my honor to be working with Jean for 4 years now and in that time I have known her to be a very flexible and hardworking supervisor and colleague. She has built a strong reputation as someone with diligence. She is someone who gets things done in no time.I have no hesitation(s) in recommending her and know that she will always give of her best in any endeavor..
Credentials
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Insurance Agent
Insurance Commission
Experience
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PMAXGlobal
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Hospitals and Health Care
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1 - 100 Employee
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Credentialing Team Lead
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Oct 2019 - Present
The Credentialing Team Lead is responsible for over seeing the team and support, ensures that the team adheres to department standards and expectations, support overall department activities (i.e. facility, governmental and commercial payer enrollment processes for providers with medical practice clinics and hospital-based groups) and other credentialing duties as assigned. Monitor team workload(s) and ensures timely completion of assigned tasksStatus Reports: Ensure status and progress of outstanding applications is properly documented and provided to Credentialing Department Supervisor and Client Managers timely and consistentlyServe as a resource to Operations (billing specialists, etc.) to answer questions and help resolve issuesCommunicate with Provider Relation reps and assist with all Payer projectsEncourage and motivate team members by creating a positive atmosphere and work environment and make sure that standards are uniformly applied and enforcedCommunicate status including critical items or hot topics regarding all client accounts and employee performance to Credentialing Department Supervisor Show less
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Credentialing Coordinator
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Feb 2019 - Sep 2019
The Credentialing Coordinator enrolls healthcare providers in governmental and commercial payer networks. It also oversees the initial client set up for new practices and maintains a current database of credentials and enrollment information. This position is responsible for enrollment processes for medical providers at healthcare clinics and hospital based groups. Enrollments will include but are not limited to practices in Louisiana, Texas, Arizona, Oregon, Washington, Illinois, Idaho, Mississippi, Nebraska, California, Georgia and Utah.*Accurately complete payer credentialing and facility appointment applications for providers.*Provides support and assistance for new practice setup as needed.*Track progress of outstanding applications and communicate with provider relation representatives ensuring enrollment completion.*Maintains accurate and current information in the provider records which includes credentialing software database and in provider electronic folders. *Maintains credential files in an orderly and current manner.*Provides research and administrative support for special projects.*Ensures HIPAA guidelines are respected by safeguarding protected health information in the capacity of the position and responsibilities. Show less
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HSA for America
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United States
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Insurance
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1 - 100 Employee
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Licensing Coordinator/Independent Contractor
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Mar 2015 - Jan 2019
High familiarity with US health care and credentialing systems like SureLC, Pinpoint, Nomoreforms. Exceptional grasp of credentialing accreditation Ensures that the insurance agency and the agents are properly licensed and certified as mandated by state and federal regulations Process insurance contracts and appointment paperworks Maintains credentialing database regarding agent training, licenses, continuing education and relevant certifications High familiarity with US health care and credentialing systems like SureLC, Pinpoint, Nomoreforms. Exceptional grasp of credentialing accreditation Ensures that the insurance agency and the agents are properly licensed and certified as mandated by state and federal regulations Process insurance contracts and appointment paperworks Maintains credentialing database regarding agent training, licenses, continuing education and relevant certifications
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Hewlett Packard Enterprise
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United States
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IT Services and IT Consulting
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700 & Above Employee
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Financial Analyst
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May 2012 - Jul 2014
Process, track and complete order and invoicing transactions Accounts receivable recovery Reconciles billing records Resolves invoice disputes and ensures billing issues are current and resolved Record keeping of working files and supporting documents Participate in month-end and year-end closing Ensure compliance with company and customer requirements for billing & invoicing Process, track and complete order and invoicing transactions Accounts receivable recovery Reconciles billing records Resolves invoice disputes and ensures billing issues are current and resolved Record keeping of working files and supporting documents Participate in month-end and year-end closing Ensure compliance with company and customer requirements for billing & invoicing
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HSA for America
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United States
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Insurance
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1 - 100 Employee
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Application and Licensing Supervisor
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Mar 2009 - May 2012
Manage Application Processors In Charge of Health and Medicare Application Processing Individual/Family Medical and Medicare Underwriting Hiring/Training New Hires Company and Advisor Licensing and Appointments Advisor Onboarding and Offboarding Process Handle Urgent Requests and Special projects as assigned Manage Application Processors In Charge of Health and Medicare Application Processing Individual/Family Medical and Medicare Underwriting Hiring/Training New Hires Company and Advisor Licensing and Appointments Advisor Onboarding and Offboarding Process Handle Urgent Requests and Special projects as assigned
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Sun Life
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Financial Services
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700 & Above Employee
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Insurance Agent
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Sep 2009 - Nov 2011
Sell insurance plans such as life insurance, variable and non-variable insurance Help individuals to choose a policy suitable to their needs Prepare proposals, deliver and explain features, advantages and disadvantages of various policies to the prospects and policyholders Ensure that policy requirements are fulfilled and the completion of appropriate forms Look for new clients and develop clientèle by networking to find new customers and generate lists of prospective clients In the event of a loss or policy matures, help beneficiaries/policyholders settle insurance claims Perform administrative tasks, such as maintaining records and handling policy renewals Attend meetings, seminars and programs to learn about new products and services, learn new skills, and receive technical assistance in developing new accounts Show less
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Babbleglass Inc.
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Philippines
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Tier 2 Chat Representative
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Oct 2007 - Jan 2009
Real-Time On-floor Management Team level outlier management Training of new operators when they join operations Manage operator attendance and schedule adherence Manage schedule roll-out and changes Swap Requests Leave Requests Agent Absenteeism Ensures that all updates and guidelines of the client gets to the agents Mentor/Coach operators on prescribed problem resolution procedures Handles supervisory escalations if and when absolutely necessary otherwise will guide the operator on how to handle said escalation Handles ticket escalations and next level support to ensure that tickets get resolved Providing Live chat help to online customers when needed Manage daily issues related to the support Responsible to meet client and company’s requirements Show less
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TTEC
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United States
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Outsourcing and Offshoring Consulting
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700 & Above Employee
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Quality Assurance Specialist
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Mar 2004 - Oct 2007
CUSTOMER SERVICE and CLIENT SATISFACTIONAttends client sessionsActive participation in QA department goals and ensure implementation of processesPro-actively assesses agent adherence to contact interaction drivers and guidelinesPhone and production support as requiredCOACHING and DEVELOPMENTMonitors Agent Customer interactions to ensure adherence to client standardsConduct one on one coaching session with agents as requiredSuggests improvements for customer interaction procedures and monitoring methodsSupport up training as applicableParticipate in the recognition process as applicablePromotes teamwork within the department and throughout the siteDEPARTMENTAL ADMINISTRATIONObjectively prepares Agent interaction performance evaluationsCreates agent/project reports of trends and observations on a daily and weekly basisReviews evaluation forms and maintain QA system filesWork on special projects, as required Show less
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Customer Service Representative
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Jul 2003 - Mar 2004
Provides support and guidance through client's customers through inbound communication channelsEnsures that all correct information is being providedReaches and maintains the metrics and quality calls in accordance with Quality Assurance GuidelinesMake sure that the customer service levels are achieved as required by the Client and OperationsManagementParticipates activities and contribute ideas as requested by the teamEnsures to deliver good work performance and positive attitude Show less
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Intelligent Private Networks
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Philippines
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Sales Associate
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Nov 2002 - Jun 2003
Responsible for product information dissemination Achieved sales quota on the first quarter of the year Handles face-to-face contacts Attends to customers concerns and complaints Made cold calls and follow up visit to prospect clients Responsible for product information dissemination Achieved sales quota on the first quarter of the year Handles face-to-face contacts Attends to customers concerns and complaints Made cold calls and follow up visit to prospect clients
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Gonzalez Law Firm
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Philippines
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Admin Assistant
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Apr 2001 - Jun 2002
Prepare correspondences and legal documents and making reports Handles general administrative duties such as filing, faxing, copying and mailing Represents the company during important events and meetings Entertain company’s clients and telephone coordinator. Prepare correspondences and legal documents and making reports Handles general administrative duties such as filing, faxing, copying and mailing Represents the company during important events and meetings Entertain company’s clients and telephone coordinator.
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Education
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1997 - 2001
University of San Jose - Recoletos
Bachelor of Science in Commerce, Business Administration
Community
