Summary
Overview
Work History
Education
Skills
Language
References
Timeline
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KRIZZA P. DE AQUINO

KRIZZA P. DE AQUINO

Talisay City

Summary

Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.

Results-driven management professional with proven ability to lead teams to success. Strong focus on team collaboration, operational efficiency, and achieving measurable outcomes. Adept at strategic planning, process improvement, and fostering culture of accountability and excellence. Known for adaptability and consistently meeting changing organizational needs.

Overview

12
12
years of professional experience

Work History

Pharmacy Escalation Manager

Foundever, US-based Pharmaceutical Company
06.2024 - 07.2025
  • US-based pharmacy distributing GLP-1 medications for better well-being to manage weight loss for those qualified patients.
  • Supervising the workflow, analytical reasoning, and providing solutions to escalated situations. Support Escalation Tier 2 agents in maintaining communications with support assignments, prioritization, scheduling, and tracking issues.
  • Receives work directions directly from the engineering managers and executive officers. Handles orders, tracking, and answering patients’ concerns and questions.
  • Managed and motivated employees to be productive and engaged in work.
  • Accomplished multiple tasks within established timeframes.
  • Enhanced customer satisfaction by resolving disputes promptly, maintaining open lines of communication, and ensuring high-quality service delivery.
  • Cross-trained existing employees to maximize team agility and performance.
  • Reduced operational costs through comprehensive process improvement initiatives and resource management.
  • Mentored junior team members for career advancement, fostering a pipeline of future leaders within the organization.
  • Streamlined workflows by identifying bottlenecks in existing systems and implementing appropriate solutions.
  • Established team priorities, maintained schedules and monitored performance.
  • Evaluated employee performance and conveyed constructive feedback to improve skills.
  • Launched quality assurance practices for each phase of development

Healthcare Insurance Verification Specialist

Foundever Inc. - US HealthCare Insurance Company
01.2020 - 01.2024
  • Enhanced claim processing efficiency by verifying insurance coverage and obtaining pre-authorizations for procedures.
  • Maintained strong knowledge of basic medical terminology to better understand services and procedures.
  • Performed various administrative tasks by filing, copying, and faxing documents.
  • Complied with HIPAA guidelines and regulations for confidential patient data.
  • Demonstrated a high level of professionalism and attention to detail in all aspects of the insurance verification specialist role, consistently exceeding performance expectations.
  • Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
  • Gained strong leadership skills by managing projects from start to finish.
  • Proven ability to learn quickly and adapt to new situations.
  • Proved successful working within tight deadlines and a fast-paced environment.
  • Worked well in a team setting, providing support and guidance.
  • Sub: Pharmacy Technician
  • Assured timely verification of insurance benefits prior to patient procedures or appointments.
  • Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
  • Trained new staff on current, correct insurance verification procedures.
  • Answered phone calls and messages for physicians, medical facilities, the billing department, in-store pharmacies, specialty pharmacies, and handled patient inquiries.
  • Assisted patients with understanding personalized insurance coverage and benefits.
  • Achieved insurance pre-authorizations to enable timely patient procedures.
  • Coordinated with care teams across various departments to ensure seamless integration of verified coverage information into overall treatment planning.
  • Assisted in training new employees on best practices for efficient insurance verification processes and procedures.
  • Increased accuracy of insurance verification, ensuring compliance with both provider and insurer requirements.
  • Improved claim submission times by streamlining verification and authorization process.

ESL Teacher

SmartBridge Learning Center
01.2019 - 01.2020
  • SmartBridge Educational Services, Remote Managed classroom effectively by establishing routines, setting expectations, and maintaining discipline throughout lessons.
  • Implemented creative teaching strategies tailored to various learning styles to maximize student comprehension and retention of material.
  • Assessed student learning needs and provided relevant instruction to close knowledge gaps.

Healthcare Customer Service Representative

Convergys
01.2014 - 01.2017
  • Maintained confidential patient, employee, and company information in compliance with company policies and regulatory requirements.
  • Providing excellent customer service by promptly answering provider inquiries.
  • Delivered exceptional support during high call volume periods by maintaining composure and professionalism under pressure.
  • Assisted in training new hires, sharing best practices in customer service protocols specific to the healthcare industry.
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Maintained up-to-date knowledge of product and service changes.
  • Identified and resolved discrepancies and errors in customer accounts.

Education

Bachelor of Science - Business Administration

07.2025

Bachelor of Science - Nursing

01.2013

Skills

  • Healthcare Industry Knowledge
  • HIPAA Compliance
  • Insurance Verification
  • Interpersonal Skills
  • Adaptable and Flexible
  • Collaboration and Teamwork
  • Workflow Development
  • Analytical Thinking
  • Team leadership
  • Task delegation
  • Strategic planning
  • Policy and procedure development
  • Adaptability and flexibility
  • Attention to detail
  • Problem-solving aptitude

Language

English
Tagalog

References

Rhystie, Yap,Team Manager, rhystie.yap@foundever.com, 09999741638


Maria Nina Valencia, Tier 2 Escalation Representative, Marianina@orderlymeds.com, 09999741638 


Frederick Mata, Team Manager at Convergys Philippines Inc., mafed1217@gmail.com, 09153298725


Michael Dan Guingona,  Operation Manager at QuickMD, 09302859390

Timeline

Pharmacy Escalation Manager

Foundever, US-based Pharmaceutical Company
06.2024 - 07.2025

Healthcare Insurance Verification Specialist

Foundever Inc. - US HealthCare Insurance Company
01.2020 - 01.2024

ESL Teacher

SmartBridge Learning Center
01.2019 - 01.2020

Healthcare Customer Service Representative

Convergys
01.2014 - 01.2017

Bachelor of Science - Nursing

Bachelor of Science - Business Administration

KRIZZA P. DE AQUINO