Account Manager

• Apr 2021 - Present

Nurse Medical Management

• Oct 2019 - Oct 2021

US RN Team Lead - Medical Review Service

• Apr 2019 - Oct 2019

I report directly to Medical Senior Medical Management Manager based in Guam. I supervised/monitor Philippine workforce to ensure we met the 24/7 business requirement of having a Medical Review Specialist available for our customer. Our team provide Utilization Management from prior authorization, concurrent review and retro review. It is also my responsibility to create and maintain a positive work environment.

Senior Supervisor - Customer Service Department

• Apr 2017 - Apr 2019

As a Senior Supervisor I report directly to Department Manager in Guam and I helped in supervising both Philippines and Guam team. My responsibilities includes making sure to monitor adequate workforce for 24/7 business requirement, review daily and monthly call volume making sure that we comply with department metrics, monitor and audit staff performance, establishing new process and policy, resolve escalate concerns by customers and maintain a positive working environment, creativity, finding ways to maintain morale within work environment.

Customer Service Supervisor

• Apr 2015 - Mar 2017

I'm a shift supervisor for a 24/7 Customer Services Department. I assist and response to members or providers inquiries, complaints, appeal and grievances. I disseminate information for new policies, acts as information source for the team members, provides instruction and assign policies, new system needed to align the staff with the department needs and direction. I promote employee development for team members through effective planning and coaching.

Dental Claims Examiner I

• Apr 2015 - Mar 2017

This is a additional job responsibility while I was a Customer Service Supervisor. I handle contracted dental provider and review then process the received claims based on the service and plan coverage. I report directly to Claims Department Supervisor.

Customer Service Representative

• Feb 2013 - Mar 2015

As a Customer Service Representative I receives documents researches and responds to member inquiries, complaints, appeals or grievances, prepare or initiate a variety of correspondences/ documents in response to inquiries, complaints, appeals or grievances, coordinates problem resolutions for members, providers and employer group and o Responsible for accurate and timely entry of claim form date according to TakeCare policy and procedures.

Customer Care Specialist Level V – Senior Staff

• Jul 2009 - Jan 2013

I facilitates out-patient availments, receives and handles availments queries of members, resolves availmetns complaints of member, otherwise elevates to the Team Leaders, assist the team leader in conducting training to new hires for the team, assist the team leader in conducting activities that monitor and enhance work performance of the staff and prepares and submits pertinent report as may be required by the Team Leader. I facilitates out-patient availments, receives and handles availments queries of members, resolves availmetns complaints of member, otherwise elevates to the Team Leaders, assist the team leader in conducting training to new hires for the team, assist the team leader in conducting activities that monitor and enhance work performance of the staff and prepares and submits pertinent report as may be required by the Team Leader.

Registered Nurse

• Dec 2008 - Mar 2009

I work as a volunteer nurse in a government hospital and I assigned at Medical Ward, Obstetrician and Gynecology Ward and Emergency Department. I work as a volunteer nurse in a government hospital and I assigned at Medical Ward, Obstetrician and Gynecology Ward and Emergency Department.