Nerika Lerize C. Muaña

NERIKA LERIZE F. CAMILE Pasay City, Philippines -​;​- skype: nl.camile27_1 Summary A detailed-minded individual combining strong personal skills; have excellent written and oral communication skills. Proven initiative and has an ability to work with minimal supervision. Graduated with Bachelor of Science Degree in Nursing in 2005. With 12 year experience in Healthcare BPO industry. Professional Skills ● ● ● ● ● ● Knowledge of utilization review procedures Excellent leadership and negotiation skills Skill in organizing and prioritizing workloads to meet deadlines Six Sigma- Yellow Belt Trained Experience in Audit and ISO certification Experience in call/claim quality evaluation Work Experience Assistant Manager | ​Collabera Technologies Private Limited Inc. | July 2017- February 2018 Makati, Philippines ​ ● ● ● Handled a max of 15-20 pharmacy benefit analyst. Monitor team members' participation to ensure the training they provided is being put into use and also to see if any additional training is needed Manage the flow of day-to-day operations Senior Specialist Consumer and Community Banking | ​JP Morgan Chase & Co. | November 2016- May 2017 BGC Taguig City, Philippines ● Provided assistance to bank employees regarding bank policies and procedures. Team Leader/Supervisor | ​Access Healthcare Services Manila Inc | January 2014- October 2016 Mckinley Hill Taguig City, Philippines ● ● ● Handled a max of 25-30 precertification coordinator agents who calls utilization department to get authorization for a high cost procedures, surgery, radiation therapy, in-patient and urgent requisitions. Monitor team members' participation to ensure the training they providing is being put into use and also to see if any additional training is needed Create reports to update the company on the team's progress Senior Quality Analyst | ​Dell Services Philippines | April 2010- January 2014 Quezon City, Philippines ● ● ● ● Conduct thorough quality check to both new hires and existing associates to ensure no repeat occurrence. Tracked continuous quality improvement (CQIP) within the program through action items designed for each area of opportunity. Resolve client complaints within 24 hours and ensure to apply corrective and preventive action [CAPA] to prevent recurring incident. Ensure 100% compliance in quality deliverables such as reports on feedback submission, rework completion, escalations. Business Development Manager | ​Portfolio Builders Pte. Ltd. ​ | January 2009- July 2009 ​ Singapore, Singapore Financial Services ● Pro-actively hunt for target organizations and establish communications with those businesses that can benefit from our Company’s services. ● Make outbound calls to prospective and existing clients ● Consolidates the file for the client valuation strategy and payment history. Senior Quality Analyst| ​Perot Systems Inc. ​ | December 2007- January 2009​ Makati, Philippines ● ● ● ● ● Evaluated a minimum of 100 claims daily. Identified error trend and formulate action plans for improvement. Conducted refresher training courses (client specific). Provided one-on-one coaching with the bottom performer for improvement. Consolidated QC reports for the ISO certification. Accounts Receivable Executive ​| ​Perot Systems Inc. ​ | April 2007- December 2007 ​ Makati, Philippines Medical Billing Services ■ ■ Make outbound calls to medical insurance (Aetna, Cigna, Humana, Optum, etc.), hospital and other health care institution to monitor if the bills or claims were paid or denied. Document all relevant information in an effective and accurate manner. ● ● ● Selected as subject matter expert on October 2007 to assist new Account Receivable Executive. Reached above 98 % quality percentage on October and November 2007 Sent to Chennai, India Perot Main Office for training of Accounts Receivable follow-up Process. Accomplishments: Customer Service Representative ​| ​Hinduja TMT Inc.​ | March 2006- March 2007 Quezon City, Philippines ​ Medical Insurance Member Services ■ Document all relevant information in an effective and accurate manner; ■ Handled all incoming calls about medical claims and benefit and eligibility inquiries. ■ Communicates with service providers and/or inter-offices worldwide to coordinate assistance for customers. ■ Graveyard shift Accomplishments: ■ Received recognition as one of the CSR who got 100% quality for the month of December and September 2006 Education Philippine College of Health and Sciences Claro M. Recto Ave. Manila, Philippines Bachelor of Science in Nursing SY- Saint Francis of Assisi College HFV Bagumbayan Taguig, Philippines Secondary Education SY- Saint Rita College Sucat Paranaque, Philippines Primary Education SY- Trainings/Seminars Attended ● ● ● ● ● ● Six Sigma Yellow Belt Certification Program​ - ​Dell, 2007 Language, Voice and Accent Training – March 2007 English Proficiency Training- March 2006 Claims Processing- March 2006 Proper Call Handling - March 2006 Client Specific training for the ff: - Medical Claims - Medical coding (HCPCS, DX codes, Procedure codes, etc.) - Health Insurance - Personal Injury Protection - Auto/ Motor Insurance - Worker's Compensation Claims - US State Laws Speedtest screenshot DISC Personality Test screenshot Typing test screenshot