Skills
Customer Support > Insurance > Prior Authorization
2-5 Years
Customer service
5-10 Years
Clinical Skills
2-5 Years
Experience highlights
Utilization Management Nurse - Prior Authorizations Reviewer
WNS
·
July/2020
–
Present
As a Prior Authorizations Nurse I was responsible for reviewing and processing prior authorization requests for advanced imaging procedures such as CT scans, MRIs, and PET scans by reviewing patient's medical chart. This role involves applying evidence-based clinical guidelines to determine medical necessity, and appropriateness.
Staff Nurse
Binan Doctors Hospital Inc.
·
May/2015
–
Present
As a Staff Nurse assigned in a Medical/Surgical/OB unit, I provide direct and individualized nursing care to patients, assessed patient needs, developed and implemented care plans, and collaborated with interdisciplinary teams to ensure high-quality, evidence-based care throughout the patient’s hospital stay. I performed comprehensive nursing assessments and document findings accurately.
Customer Service Representative
TeleTech
·
November/2009
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Present
As a Customer Service Representative for Telstra Business I provided dedicated support to small business clients. This role focuses on delivering exceptional service, resolving technical and account-related issues, and ensuring Telstra’s business customers receive timely, effective solutions that support their operations.
Customer Service Representative
Convergys
·
May/2008
–
Present
Worked as a Customer Service Representative for a US-based telecommunications company, Sprint. Handled inbound calls regarding mobile plans, billing, device troubleshooting, and service upgrades. Provided accurate information about Sprint products, services, and promotions. Resolved customer complaints efficiently and empathetically, escalating complex issues as needed. Process payments, set up new accounts, and assist with account modifications.
