Christian Lois Tan
Conifer WFH
Malabon, Metro Manila
8
years of professional experience
Dynamic professional experienced in medical claims examination and dispute resolution. Skilled in teamwork, attention to detail, and multitasking, with a track record of mentoring junior staff and guiding teams through complex case challenges.
Work History
Claims Examiner Specialist
4 Months- Analyzed policy provisions, medical records, and supporting evidence for accurate claim decisions.
- Processed claims within claims management systems while maintaining compliance with guidelines and regulations.
- Investigated discrepancies, missing information, and disputes to resolve claims efficiently.
- Maintained current knowledge of industry developments, regulations, and best practices through continuous professional development activities.
Provider Dispute Resolution Specialist
9 Months- Collaborated with team members to streamline case handling procedures, enhancing efficiency.
- Resolved disputes by expertly analyzing cases and implementing effective processing strategies.
- Drove dispute resolutions using effective problem-solving and by guiding mutual understanding of opposing viewpoints.
- Reviewed legal documents and contracts to determine potential conflicts and disputes.
Medical Claims Examiner
6 Years 1 Month- Reviewed and adjudicated medical claims for accuracy, ensuring compliance with policies and regulations.
- Analyzed claim submissions to identify discrepancies and resolve issues efficiently.
- Trained and mentored junior staff on claim processing procedures and best practices.
- Supported team members during periods of high workload, providing guidance on challenging cases or offering assistance when needed.
- Paid or denied medical claims based upon established claims processing criteria.
Education
Bachelor of Science - Computer Science
Skills
Dispute analysis
Teamwork and collaboration
Problem-solving
Attention to detail
Time management
Multitasking
Accomplishments
Pinnacle Performer of the Year Award (Perfect Quality Scores from Sept 2022 - July 2023)
Timeline
Claims Examiner Specialist
Conifer WFH
06.2026 - CurrentRead More
Provider Dispute Resolution Specialist
Imagenet
09.2025 - 06.2026Read More
Medical Claims Examiner
Accenture
01.2019 - 02.2025Read More
Asian Institute of Computer Studies
Bachelor of Science from Computer Science
Read More