Hi, I’m
Erika Lei B. Tan
Lapu-lapu City, Cebu
Summary
Detail-oriented and results-driven healthcare and operations professional with over 10 years of diverse experience spanning clinical nursing, claims processing, training, and quality assurance. Adept at leading teams, streamlining workflows, and delivering actionable insights to improve process efficiency. Strong analytical thinker with a proven track record of driving results in high-pressure environments.
Overview
13
years of professional experience
1
Certification
Work History
Optum
Senior Operations Trainer
09.2023 - Current
Job overview
- Conduct onboarding sessions, refresher courses, and upskilling workshops on clinical review protocols, documentation standards, and health insurance guidelines (Commercial plans).
- Collaborate with operations managers, quality analysts, and clinical leads to identify training needs and implement targeted learning solutions that improve team performance and compliance.
- Evaluate learner progress through assessments, audits, and coaching, ensuring alignment with federal state regulations and company standards.
- Maintain and update training materials to reflect evolving healthcare policies, system updates, and best practices in remote clinical work.
- Utilize virtual platforms (MS Teams) for engaging and effective delivery of remote training programs.
- Mentor and support nurses post-training to ensure smooth transition into production roles and continued professional development.
Optum
Recovery Resolutions Analyst | SME | Trainer | QA
02.2021 - 09.2023
Job overview
- Streamlined claims processing through workflow improvements, enhancing team productivity.
- Led training for over 40 team members, covering policies, procedures, and process best practices.
- Performed root cause analysis to resolve operational issues, reducing error rates.
- Conducted quality audits and developed reports with data-driven recommendations.
- Collaborated weekly with SMEs and stakeholders for process alignment and updates.
Optum
Pharmacy Benefits Analyst
06.2020 - 01.2021
Job overview
- Validated and entered employee benefit enrollments, ensuring database accuracy.
Optum
Claims Representative
03.2020 - 05.2020
Job overview
- Processed high-volume insurance claims and calculated necessary adjustments and reimbursements.
Optum
Appeals Coordinator | QA
06.2019 - 03.2020
Job overview
- Audited appeal and grievance cases, ensuring compliance and timely resolution.
Optum
Appeals Coordinator
06.2018 - 06.2019
Job overview
- Managed case documentation and swiftly resolved data discrepancies.
TripAdvisor via OAMPI
Content Moderator & Fraud Analyst
07.2014 - 01.2018
Job overview
- Reviewed and approved user-generated content for accuracy and compliance.
- Conducted fraud analysis and maintained content integrity.
UHS Philippines
Sales Associate
06.2012 - 06.2014
Job overview
- Delivered exceptional customer service and exceeded sales targets through consultative selling.
St. Luke's Medical Center – Global City
Staff Nurse (OPD)
02.2012 - 06.2012
Job overview
- Provided comprehensive patient care, administered medications, and assisted in clinical procedures.
- Maintained detailed medical records and supported physicians in patient treatment planning.
Education
Trinity University of AsiaQuezon City
Bachelor of Science from Nursing
04.2011
University Overview
- Graduated Cum Laude
- GPA: 1.70
Skills
- Process Improvement & Root Cause Analysis
- Training & Coaching
- Quality Assurance & Auditing
- Claims & Benefits Administration
- Critical Thinking & Problem Solving
- Communication & Collaboration
- Organizational and Time Management
Certification
- Completed the New Manager Program (March 7–9, 2022)
- Passed OGA Way to Train – Cycle 1 (Trainer Certification Program)
Timeline
Senior Operations Trainer
Optum
09.2023 - Current
Recovery Resolutions Analyst | SME | Trainer | QA
Optum
02.2021 - 09.2023
Pharmacy Benefits Analyst
Optum
06.2020 - 01.2021
Claims Representative
Optum
03.2020 - 05.2020
Appeals Coordinator | QA
Optum
06.2019 - 03.2020
Appeals Coordinator
Optum
06.2018 - 06.2019
Content Moderator & Fraud Analyst
TripAdvisor via OAMPI
07.2014 - 01.2018
Sales Associate
UHS Philippines
06.2012 - 06.2014
Staff Nurse (OPD)
St. Luke's Medical Center – Global City
02.2012 - 06.2012
Trinity University of Asia
Bachelor of Science from Nursing
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