Summary
Overview
Work History
Education
Skills
Certification
Accomplishments
Timeline
Generic

Jaquilyn Nabices

Caloocan City, Metro Manila,00

Summary

Experienced with managing appeals and dispute resolution processes effectively. Utilizes analytical skills to assess and resolve complex cases while ensuring compliance with regulatory standards. Track record of collaborating with teams to deliver timely and accurate outcomes, adapting to changing needs and requirements.

Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.

Overview

9
9
years of professional experience
1
1
Certification

Work History

Appeals Specialist

Accenture, Inc.
01.2018 - 10.2024
  • Collaborated with cross-functional teams to gather necessary documentation and evidence to support the appeals process.
  • Managed high-stress situations with professionalism, ensuring that appeals were handled promptly and accurately even under tight deadlines or heavy caseloads.
  • Maintained high levels of accuracy in all written correspondence, ensuring clear communication with relevant stakeholders during the appeals process.
  • Achieved successful appeal outcomes by meticulously reviewing and analyzing claim denials, identifying errors, and presenting persuasive arguments.

Healthcare Data Analyst (Frontline Process)

Accenture, Inc
05.2015 - 12.2017
  • Collaborated with cross-functional teams for comprehensive data analysis and insights.
  • Improved data accuracy by conducting thorough data validation and cleansing processes
  • Mentored junior analysts in best practices associated with healthcare data analytics methodologies, contributing to a well-informed and highly skilled team.
  • Identified opportunities for process improvement through detailed assessment of existing workflows and systems integration challenges.

Education

Bachelor of Science - Banking And Finance

UNIVERSITY OF CALOOCAN CITY
Caloocan City, Metro Manila, Philippines
04-2015

Skills

  • Continuous learning mindset
  • Strong analytical skills
  • Data entry proficiency
  • Documentation expertise
  • Multitasking
  • Claims Investigation
  • Problem-solving abilities
  • Reliability
  • Claims adjustment
  • Conflict Resolution
  • Policy Interpretation
  • Quality Control
  • Denied claims identification
  • Dispute Resolution

Certification

COBE Fundamentals

MESH Training

Technology Quotient FY24

Accomplishments

FY 24 Q3 ALIST Awardee

Best People Award

Hall of Fame Awardee

FY24 Monthly Superstar Awardee

Client Value Creation Award

Timeline

Appeals Specialist

Accenture, Inc.
01.2018 - 10.2024

Healthcare Data Analyst (Frontline Process)

Accenture, Inc
05.2015 - 12.2017

Bachelor of Science - Banking And Finance

UNIVERSITY OF CALOOCAN CITY

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Jaquilyn Nabices