Jimmarie Ganial
Customer Service Representative
Metro Manila, Metro Manila, Navotas City, Bangculasi
Summary
Detail-oriented professional with expertise in appointment scheduling, patient communication, and claims processing. Proven ability to streamline operations and enhance patient experiences, contributing to improved satisfaction and efficiency.
Overview
8
8
years of professional experience
Work History
Client Partner
Access Healthcare
10.2025 - 06.2026
- Appointment Coordination
Schedule, reschedule, and cancel patient appointments.
Manage provider calendars to balance workloads and minimize conflicts.
Maintain waitlists and fill vacancies promptly. - Patient Communication
Confirm appointments and provide pre-visit instructions.
Answer patient inquiries regarding forms, insurance, and clinic policies.
Serve as the first point of contact, ensuring a positive patient experience. - Data Management
Verify patient demographics, insurance, and referral information.
Update electronic health records (EHR) with accurate scheduling details.
Generate daily schedules and reports for medical staff. - Collaboration with Staff
Coordinate with doctors, nurses, and administrative teams.
Relay urgent scheduling requests and resolve conflicts.
Ensure compliance with insurance pre-authorization requirements.
Patient Care Coordinator
MiraMed
01.2025 - 01.2026
- Claims Processing
Prepare, review, and submit medical claims to insurance providers.
Ensure proper coding (CPT, ICD-10, HCPCS) before submission.
Monitor claim status and follow up on unpaid, delayed, or rejected claims. - Denial Management
Handle claim corrections, resubmissions, and appeals.
Investigate billing discrepancies and coding-related issues.
Identify denial trends and recommend corrective actions. - Insurance Verification
Verify patient insurance coverage, benefits, co-pays, and deductibles.
Communicate insurance details clearly to patients and internal teams. - Documentation & Compliance
Maintain accurate records of payment postings, adjustments, and billing activity.
Ensure compliance with HIPAA and healthcare regulations.
Stay updated on insurance policies, coding standards, and billing procedures.
Patient Care Coordinator
Vee Technologies
10.2023 - 01.2025
- Primary Responsibilities
Answer inbound and make outbound calls to patients.
Verify patient identity before sharing information.
Handle insurance queries, collect missing details, and escalate unresolved issues.
Obtain insurance details, referral information, and PCP (Primary Care Provider) information.
Document disputes, objections, and demographic mismatches (e.g., name/DOB).
Update patients on out-of-pocket expenses and coordinate accident/work-related claim details.
Schedule, cancel, and remind patients of appointments. - Secondary Responsibilities
Maintain professional decorum and punctuality.
Follow compliance, privacy, and security protocols.
Attend refresher sessions and adhere to organizational policies.
Report any security/privacy incidents.
Uphold confidentiality agreements and SLA requirements
Customer Service Representative
ContinuumGlobal
10.2019 - 05.2023
- Customer Service & Operations
Assist members with benefits, claims, and billing inquiries.
Provide clear guidance on coverage, eligibility, and provider networks.
Document interactions and escalate complex cases. - Clinical Solutions
Support Medicare and Medicaid members with medical management services.
Work in areas like behavioral health, wellness programs, and care coordination.
Collaborate with providers to improve patient outcomes. - Service Operations
Advocate for members’ health by helping them maximize benefits.
Build trust and provide a clear path to care.
Customer Service Representative
Results Companies
03.2019 - 10.2019
- Customer Service Representative
Assist customers with account setup and eligibility verification.
Troubleshoot device issues (phones, SIM cards, connectivity).
Answer questions about available services and Lifeline benefits.
Handle high volumes of inbound calls/messages.
Document interactions in CRM systems and escalate complex cases. - Sales & Outreach Roles
Promote free government phones and tablets under the Lifeline program.
Engage with communities to explain benefits and eligibility.
Often commission-based, requiring energy and strong people skills. - Lifeline Agent
Remote or field-based positions focused on enrolling customers.
Ensure compliance with federal Lifeline regulations.
Collect and verify required documentation.
Customer Service Representative
Inspiro (Formerly SPi CRM) - Head Office
01.2018 - 06.2018
- Customer Service Support
Handle inbound and outbound calls related to flower and gift orders.
Assist customers with product selection, order placement, and payment processing.
Provide delivery updates and resolve issues such as late or incorrect orders. - Order Management
Enter and verify customer information in the system.
Coordinate with florists and logistics partners to ensure timely delivery.
Manage cancellations, refunds, and replacements. - Sales & Upselling
Suggest add-ons like chocolates, balloons, or premium bouquets.
Promote seasonal offers and loyalty programs (e.g., Celebrations Passport).
Education
Bachelor of Science - Information And Communication Technology
Marry The Queen College
Quezon City, Metro Manila, Philippines 04.2001 -
Skills
Patient communication
Patient scheduling
Insurance Billing
Appointment coordination
Insurance verification
Timeline
Client Partner
Access Healthcare
10.2025 - 06.2026
Patient Care Coordinator
MiraMed
01.2025 - 01.2026
Patient Care Coordinator
Vee Technologies
10.2023 - 01.2025
Customer Service Representative
ContinuumGlobal
10.2019 - 05.2023
Customer Service Representative
Results Companies
03.2019 - 10.2019
Customer Service Representative
Inspiro (Formerly SPi CRM) - Head Office
01.2018 - 06.2018
Bachelor of Science - Information And Communication Technology
Marry The Queen College
04.2001 -