JOHN PAUL SUCILAN
Taguig City
Summary
I am dedicated to extending my capabilities to others, fostering an environment rich in guidance where collective goals promote independence and diverse unity. My focus is on empowering individuals to thrive while working collaboratively toward shared objectives.
Overview
3
3
years of professional experience
Work History
Senior Process Executive
Premera Blue Cross
Taguig
12.2024 - Current
- In charge of processing appeals from providers, ensuring timeliness, and making sure necessary information is present for an appeal to go through.
- Created detailed documentation for each process to ensure compliance with regulations.
- Maintain accurate records of appeals, including submission dates, correspondence, and outcomes.
- Respond to provider offices to explain the reasons for the appeal denial.
- Review clinical documentation within my scope to produce a decision for the appeal.
- Coordinate with the clinical team for clinical documentation that requires their review, and monitor their findings to create an outcome and communicate it with the provider.
Associate Trainer
ANTHEM BLUE CROSS BLUE SHIELD
Taguig
03.2024 - 07.2024
- Ensures compliance with company policies, fostering a culture of integrity among associates
- Imparts expertise on products and processes to new hires, facilitating their onboarding experience
- Monitors trainee performance closely, providing constructive feedback to drive individual growth
- Develops engaging learning materials to enhance the effectiveness of training sessions
- Analyzes trainee data to track progress and ensure the success of associates
- Serves as the primary support system for new employees, addressing questions and resolving issues related to products and company operations
- Collaborates with various departments to streamline administrative tasks and optimize operational efficiency
Floor Support
ANTHEM BLUE CROSS BLUE SHIELD
Taguig
11.2023 - 02.2024
- Distributes process-related updates to ensure compliance and efficiency among teammates
- Provides assistance by addressing various concerns and managing escalated calls
- Conducts time-keeping, schedule management, and team huddles in support of the team leader
- Facilitates team discussions to foster a positive atmosphere and enhance morale
Customer Care Representative I
ANTHEM BLUE CROSS BLUE SHIELD
Taguig
06.2023 - 10.2023
- Expertly assists healthcare holders in understanding and utilizing their policy benefits for optimal medical service delivery
- Effectively coordinates patient interactions with medical providers, ensuring comprehensive management of their health care needs
- Acts as a frontline advocate, addressing patient needs with empathy and professionalism, even in complex situations
- Ensures rigorous adherence to product procedures and policies, maintaining the highest standards of service compliance
- Demonstrates exceptional knowledge absorption and allocation to enhance service efficiency and client satisfaction
- Facilitated policy navigation, enhancing patient satisfaction with services
WISE - CALL CENTER ASSOCIATE
Makati
10.2022 - 02.2023
- Engaged customers via phone and email to resolve complex queries swiftly
- Provided expert assistance on business account setup and management
- Delivered tailored support to enhance customer satisfaction and retention
- Utilized in-depth product knowledge to boost sales and drive customer loyalty
BRAVIANT - COLLECTIONS AGENT
Taguig
07.2022 - 08.2022
- Delivered exceptional customer service to enhance client relations
- Actively negotiated payment plans, increasing successful debt recovery
- Facilitated communication between businesses and customers to resolve balances
- Drove revenue growth by efficiently managing debt collection processes
Education
SENIOR HIGH -
WESTERN BICUTAN NATIONAL HIGH SCHOOL
TAGUIG CITY01.2022
JUNIOR HIGH -
WESTERN BICUTAN NATIONAL HIGH SCHOOL
TAGUIG CITY01.2020
ELEMENTARY -
GUMAUS ELEMENTARY SCHOOL
PARACALE, CAMARINES NORTE01.2015
Skills
- Applied Data Interpretation and Analysis
- Business Process Improvement
- Collaborative Communication
- Data Entry and Documentation
- Adaptive Tool Navigation
- Record management
- Clinical review
- Compliance documentation
Hobbies and Interests
- Having intellectual conversations
- Open World adventure Games
- Technological Functions
- Scientific Studies
Timeline
Senior Process Executive
Premera Blue Cross
12.2024 - Current
Associate Trainer
ANTHEM BLUE CROSS BLUE SHIELD
03.2024 - 07.2024
Floor Support
ANTHEM BLUE CROSS BLUE SHIELD
11.2023 - 02.2024
Customer Care Representative I
ANTHEM BLUE CROSS BLUE SHIELD
06.2023 - 10.2023
WISE - CALL CENTER ASSOCIATE
10.2022 - 02.2023
BRAVIANT - COLLECTIONS AGENT
07.2022 - 08.2022
SENIOR HIGH -
WESTERN BICUTAN NATIONAL HIGH SCHOOL
JUNIOR HIGH -
WESTERN BICUTAN NATIONAL HIGH SCHOOL
ELEMENTARY -
GUMAUS ELEMENTARY SCHOOL