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, Philippines04-2015
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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