CHEENEE PASIA DOTADO

• Evaluated medical claims for eligibility, ensuring compliance with policy guidelines. • Handled inquiries from primary insurance companies, brokers, and customers via calls and emails. • Supported new staff through training, nesting, shadowing, and post-training sessions. • Acted as Shift Supervisor, managing complaint callbacks and escalated communications. Coordinated with senior staff and departments to resolve escalated issues. • Resolved complex customer inquiries and complaints with accurate, empathetic responses. • Analyzed and resolved issues using internal systems and tools, escalating when necessary. Followed standard operating procedures to ensure consistent service quality.

• Evaluated claims with regards to eligibility, ensuring accuracy and compliance with company policies. • Managed inbound calls and assisted customers with specific inquiries efficiently and professionally. • Promoted company services and products to increase customer engagement and interest. • Maintained and updated the existing database with member status and relevant changes. • Documented telephone conversations and actions taken for accurate record- keeping. • Analyzed problems thoroughly and developed logical solutions within the authorized scope of work. • Maintained clear communication channels with the Care Centre Supervisor and Manager to ensure smooth operations.

• Ensured continuity of service across multiple specialties by managing general office coverage, handling phone calls, and performing daily data entry. • Provided patients with accurate information and efficiently transferred phone calls and queries to the relevant departments. • Assisted patients with inquiries and support throughout their visit. • Handled billing for all Laboratory and Radiology procedures accurately and timely. • Scheduled appointments for all Radiology procedures, coordinating with patients and medical staff. • Delivered clear instructions to patients regarding preparation for approved Radiology procedures.

• Patient Care. • Nursing operations. • Ward cleaning.

• Assessed and evaluated medical claims for eligibility and approval in accordance with company policies. • Performed daily data entry with high accuracy and attention to detail. • Provided accurate information to customers and routed calls to appropriate departments. • Reviewed and validated physician-ordered procedures. Obtained and verified patients’ medical information for processing and coordination. • Resolved customer complaints and escalated complex inquiries to ensure proper resolution.