RACHELLE ANN RANES
Calatagan, Batangas, Philippines--
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SUMMARY
A results-driven and detail-oriented professional with over 8 years of experience with Healthcare
Account in BPO industry, specializing in eligibility and benefits, medical billing, claims processing,
credentialing and administrative operations. Known for strong organizational skills, high accuracy, and
the ability to manage sensitive healthcare data with confidentiality and compliance.
WORK EXPERIENCE
Team Leader, Concentrix Daksh PH.
Jan 2023 - Jun 2023
Supervise daily operations of a team handling healthcare processes in Credentialing.
Ensure all work complies with HIPAA, client-specific guidelines, and quality standards.
Track individual and team KPIs (Key Performance Indicators) such as SLA adherence, NPS, CSAT
and Quality and Assurance.
Serve as the point of contact between the client and the team for updates, escalations, and
performance feedback.
Foster a positive work environment and promote teamwork, accountability, and recognition.
Nov 2021- Jan 2023
Subject Matter Expert, Concentrix Daksh PH.
Serve as the go-to resource for process-related queries and escalations from team members
and supervisors.
Support quality audits by providing clarifications and insights into guidelines or client
expectations.
Participate in calibration sessions and continuous improvement initiatives
Support team leads and managers in decision-making by providing expert insights.
Healthcare Representative, Concentrix Daksh PH.
Jun 2016 - Nov 2021
Verify patient insurance eligibility, benefits and confirming coverage for specific services,
including copay, deductible, and authorization requirements.
Provide status updates, clarify billing concerns, and guide users through claims or credentialing
processes.
Ensure all notes and updates are clear, complete, and audit-ready.
Healthcare Representative, Alorica
Jun 2015 - Jun 2016
Assists with inquiries related to insurance eligibility and benefits, claim submissions and status
updates, and appeal follow-ups.
Ensures accurate information delivery, resolves issues professionally, and complies with HIPAA
and client protocols.
Accurately log all interactions, outcomes, and follow-ups in CRM or client systems.
EDUCATION
STI College
Bachelor in Secondary Education
Major in Computer Education
Cum Laude
Jun 2011 - May 2015
SKILLS
Detail-Oriented
Problem-Solving
Time management and task prioritization
Adaptable
Critical Thinking
Calendar and email management
Management Skills
Decision-making
HIPAA compliance and data confidentiality
