Jewel Alyssa Garcia
Manila, Metro Manila,00
Summary
Results-driven Healthcare Operations Leader with over 7 years of experience in team supervision, credentialing, and provider relations. Proven track record of optimizing workflows at Mochi Health and Pacific Health Works to improve operational efficiency and patient satisfaction. Expert in HIPAA compliance and maintaining 100% accuracy in high-volume healthcare environments.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Team Lead
Mochi Health
Remote
05.2023 - 12.2025
- Led daily operations for a 12-member customer service team, consistently exceeding performance targets by 20%.
- Streamlined prescription refill and prior authorization workflows, reducing patient wait times by 2 hours and improving submission accuracy by 25%.
- Conducted weekly coaching and performance reviews, resulting in a 30% increase in team productivity and multiple internal promotions.
- Managed scheduling, workload distribution, and escalation resolution, resolving 90% of complex cases within 24 hours.
- Maintained a 98% quality assurance score and ensured 100% compliance with company policies and regulatory guidelines.
Provider Relations Coordinator - Credentialing Lead
Pacific Health Works
Remote
08.2021 - 05.2023
- Managed end-to-end credentialing and re-credentialing lifecycle for 50+ healthcare providers, ensuring 100% compliance with NCQA, CAQH, TJC and state regulations.
- Optimized onboarding workflows, reducing time-to-enrollment by 35% and accelerating provider revenue generation.
- Audited and maintained 500+ provider files, achieving a 99% accuracy rate during internal and external audits.
- Served as primary liaison between providers and 5 internal departments, resolving credentialing bottlenecks and improving turnaround time by 30%.
- Directed training and oversight for 8 credentialing staff, increasing file processing volume by 40% through process improvements.
Credentialing Coordinator
Accenture Inc.
Quezon City, Metro Manila, Philippines
08.2020 - 08.2021
- Coordinated credentialing and re-credentialing for 100+ providers, ensuring timely documentation and verification.
- Maintained regulatory records with 98% data accuracy, supporting audit compliance.
- Reduced processing delays by 25% through proactive application monitoring and issue resolution.
- Collaborated with insurance carriers, regulatory agencies, and providers to meet submission deadlines.
Customer Service Representative
Alorica Inc.
02.2018 - 08.2020
- Supported 60+ patients daily with insurance verification, authorizations, and claims processing.
- Handled appeals and grievances with 97% accuracy, improving first-contact resolution.
- Reduced repeat inquiries by 20% through effective problem-solving and follow-up.
- Maintained detailed documentation in compliance with HIPAA and payer requirements.
Education
Bachelor of Science - Physical Therapy
Arellano University
Manila, PH01.2018
Skills
- Leadership: Team Supervision, Performance Coaching, Conflict Resolution
- Operations: Credentialing Lifecycle, Regulatory Compliance, Quality Assurance
- Technical: Data Analysis, Reporting, Microsoft Office Bootcamp, Google Workspace
- Healthcare: Medical Scribing, Insurance Verification, Prior Authorizations, Referrals, Claims & Appeals
Certification
- Basic Life Support and First Aid Training - Philippine Heart Association - 2022
- HIPAA Compliance Certification - HIPAA Training - 2025 until 2027
- Leadership and Management
- Excel Bootcamp - Evrovuotika Robotics and Automation Solutions - 2021
Timeline
Team Lead
Mochi Health
05.2023 - 12.2025
Provider Relations Coordinator - Credentialing Lead
Pacific Health Works
08.2021 - 05.2023
Credentialing Coordinator
Accenture Inc.
08.2020 - 08.2021
Customer Service Representative
Alorica Inc.
02.2018 - 08.2020
Bachelor of Science - Physical Therapy
Arellano University