KIMBERLY OREJOLA
MARIGONDON
Summary
To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills. Organized and dependable candidate successful at managing multiple priorities with a positive attitude. Willingness to take on added responsibilities to meet team goals.
Overview
3
3
years of professional experience
Work History
Precertification Coordinator
Access Healthcare
Taguig
03.2021 - 12.2022
- Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
- Used critical thinking to break down problems, evaluate solutions and make decisions.
- Collaborated with team members to achieve target results.
- Verified insurance coverage and obtained pre-authorizations.
- Expertly managed planning, scheduling and coordination of outpatient procedures.
Inbound Customer Service Representative
Sykes Philippines
Cebu
09.2020 - 03.2021
- Used consultative sales techniques to understand customer needs and recommend relevant products and services.
- Built long-term, loyal customer relations by providing top-notch service and detailed order, account and service information.
- Answered product and service questions, suggesting other offerings to attract potential customers.
- Furnished accurate product information and shipping instructions and offered alternatives for out-of-stock items to support customer buying decisions.
- Resolved complaints to satisfy customers and encourage future transactions.
- Answered phone with friendly greeting to create positive inbound calling experience for customers.
Prior Authorization Technician
Optum - United Healthcare
Cebu
10.2018 - 03.2019
- Processed patients lacking coverage for planned procedures.
- Verified eligibility and compliance with authorization requirements for service providers.
- Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
- Assessed information gleaned from interviews, educational and medical records, consultation with other professionals and diagnostic evaluations to identify clients' abilities, needs and eligibility for services.
Education
Bachelor of Science - Pharmacy
Cebu Doctors' University
Mandaue City10.2017
Skills
- Staff Training
- Benefits Verifications
- Obtaining Authorizations
- Precertification Processing
- Team Management
- Issue Resolution
- Specialty Care
- Referral Verification
- Administrative Support
Timeline
Precertification Coordinator
Access Healthcare
03.2021 - 12.2022
Inbound Customer Service Representative
Sykes Philippines
09.2020 - 03.2021
Prior Authorization Technician
Optum - United Healthcare
10.2018 - 03.2019
Bachelor of Science - Pharmacy
Cebu Doctors' University
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