Joan Arevalo

JOAN P. AREVALO Bldg. 17 Dirar Bin Al Khattab St. Al Mansoura, Doha Qatar Contact no.: +974 - Email Address:-Objective: To work in an organization which offers a challenging opportunity to enhance my knowledge, skills and experience that would allow me to contribute towards achieving the organizational goals to the best of my potential. Skills:       High level of multi-tasking capabilities and ability to work under extreme pressures with minimal supervision in a leading organization. More than 5 years handling claims processing for healthcare and mobility insurance companies based in United States and United Kingdom. Experience in handling various computer software applications aids in office related management tasks. Strong communication skills, time management and planning task. Dynamic and self-directed professional with experience in management staff support. Amicable personality matching customer service requirements. Work Experience: Asurion-TCP Inc. Carmelray Industrial Park II, Brgy. Punta, Calamba City Laguna 25th January, 2015 – 09th November, 2016 Title: Mobility Insurance claims coordinator Responsibilities:  Oversaw account to ensure up-to-date team data and information for higher management monitoring reference.  Tracked team’s performance on a daily manner. Provide high level of product and leadership support to representatives and clients.  Monitor daily activities of the team and provide status report for achievement and challenges of the team to the higher management which includes operations manager and country director.  Immediately address challenges of the team that impact team product or deliverables.  Creating a calendar and keeping track of the training schedules of the entire team with the client. Liaise with UK client for work instructions and updates as required.    Generate and delegate daily workloads from 17 line-of-business of the account to appropriate personnel and simultaneously monitor compliance on designated turn-around-time of each workload. Consistently improves and maintain 100% quality delivered to clients and increase production output by developing strong knowledge of account’s products and services and pass the same to the team. Begin to train new representatives after only 6 months of employment. Awards:  Certificate of recognition for Highest Quality Score  Best of the Best Award (Best Associate 2016) Affiliation:  Representative for Knowledge-Based council - integrated new process and improvement plan to our client in redesigning our work instruction that played an instrumental role in increasing customer service satisfaction. UnitedHealth Group, Inc. 9th Floor, Science Hub Bldg., Tower 1, Block 38 Campus Avenue Corner Turin St., McKinley Hill Town Center, Fort Bonifacio, Taguig City 1634 Philippines April 16, 2012 – June 18, 2013 Title: Insurance Enrollment Administrator (Healthcare Account) Responsibilities:  Manage electronic enrollment documentation of insurance subscribers.  Identify, understand and design benefit system of the customers on the online processing database.  Ensures accurate data and information encoded on the plan purchased by the customer for correct payment and denial of insurance.  Reviews health benefits that form part of the inclusions and exclusions of their plans.  Claims systems utilization, capacity analysis/planning and reporting. Award:  Certificate of Recognition as one of the Top 5 Rising Stars of the Training (20 th July, 2012) EXL Service Inc. 6th floor One E-com bldg., MOA complex ground. Pasay City February 28, 2011 – March 30, 2012 Title: Claims Coordinator (Healthcare Account) Responsibilities:  Doing inbound and outbound calls from the medical providers for status, verification and negotiation of their Liens.  Responsible for analyzing case reports, reprocessing medical bills to address client’s payment or denial disputes.  Understand and check if accurate medical coding was use and if medical record falls under Workers’ Compensation benefits.  Process, control and administer incoming and outgoing documentation (billing, medical records, and correspondence) Accenture Inc. 27th Floor, Cybergate Tower 2, Pioneer St. Boni Ave. Mandaluyong City April 2008 – February 28, 2011 Responsibilities:  Senior Claims Analyst – Ability to resolve hard and soft edits on the claims, reprocess manual claims with errors. Analyze and study claims cases for payment or denial of claims.  Quality Assurance Auditor (pre-pay and post-pay audit) – Audit and review processed claims and provide accurate feedback to team members.  Team trainer (Image Team) – provide process training to newly-hire associates.  Internal Subject-Matter Expert (Image Team) – do the floor-walk assistance to the team regarding process queries and billing concerns.  Medical Claims Adjuster and High-Dollar claims adjuster – Adjusting disputed claims, handling maternity billing and ability to review if the newborn billing can be filed under the mother’s billing. Expertise in analyzing all kinds of high-dollar bills including but not limited to inpatient claims. Reviewing medical records to validate accurate coding on surgery cases, ambulatory surgeries and all kinds of high dollar claims exceeding $50,000.00. Awards:  Integrity Award (29th September, 2010)  Most Effective Trainer / SME award (29th September, 2010)  Multi-Task Award (19th June, 2010) EDUCATIONAL ATTAINMENT: Tertiary: Dr. Filemon C. Aguilar Memorial College Golden Gate Subd., Talon III Las Piñas City Bachelor of Science in Business Administration Major in Management 2004 – 2008 - Graduated Secondary: Las Piñas National High School Tabon I, E. Aldana Rd., Las Piñas City 1998 – 2002 - Graduated Primary: Zapote Elementary School Tramo, Zapote Las Piñas City 1992 – 1998 – Graduated ON-THE-JOB TRAINING: Washington International Language Centre (WILC) Penthouse Floor, Washington Tower, Asiaworld City, Aguinaldo Boulevard, Parañaque City Administrative Assistant March 15 - May 28, 2007 I hereby certify that the above information are true and correct up to the best of my knowledge and belief. JOAN PINEDA AREVALO +974 -