Ma. Andrea Amor Escarola
Mandaluyong City, Metro Manila
Summary
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Prior Authorization Specialist
Carelon Global Solutions Inc.
04.2023 - 02.2025
- Maintained thorough knowledge of insurance plan requirements, facilitating accurate and timely completion of authorization forms.
- Verified eligibility and compliance with authorization requirements for service providers.
- Maintained organized records and up-to-date files for all completed and pending authorization requests, ensuring easy access during audits or reviews.
- Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
Medical Prep Specialist
Carelon Global Solutions Inc.
04.2023 - 02.2025
- Thoroughly review and analyze medical documents submitted by the claimant.
- Sort and organize medical documents
- Produce a fully summarized medical report for legal and insurance claim purposes.
Customer Service Representative
Carelon Global Solutions, Inc.
04.2023 - 02.2025
- Managed high outbound call volume with exceptional professionalism and efficiency.
- Ensure prescribed medications meet insurance criteria.
- Addressing customer inquiries regarding medications and insurance coverage.
- Maintaining data privacy and compliance with HIPAA regulations.
Technical Support Representative
Concentrix
12.2020 - 01.2023
- Provided remote assistance to customers experiencing technical difficulties, guiding them through step-by-step resolutions with patience and professionalism.
- Improved customer satisfaction by providing timely and accurate technical support for various software and hardware issues.
- Resolved complex technical problems through effective troubleshooting techniques, enhancing the user experience.
- Maintained a high level of expertise on company products, ensuring accurate information was provided to customers at all times.
- Managed high levels of call flow and responded to technical support needs.
- Conducted thorough research on reported issues, identifying root causes and implementing effective fixes to prevent future problems.
Travel Staff
HIS Global Business Inc.
03.2019 - 03.2020
- Taking in guests' special requests and inquiries through email.
- Verifying guest reservations, manage amendment request and cancellation requests.
- Share information with the front desk, management and other departments.
Outbound Sales Representative
BD BPO Solutions
08.2017 - 08.2018
- Increased sales revenue through strategic cold calling and lead generation activities.
- Exceeded personal sales goals by leveraging persuasive communication skills and product knowledge expertise.
- Supported colleagues as needed, contributing positively towards creating a cohesive team culture focused on achieving collective objectives.
- Utilized CRM systems for tracking leads, managing customer information, and prioritizing daily tasks efficiently.
Education
Bachelor of Science - Business Administration And Management
Jose Rizal University
Mandaluyong City, Metro Manila, PhilippinesAssociate - Midwifery
Iloilo Doctors' College
Iloilo City, Province Of Iloilo, PhilippinesSkills
- Prior authorization process
- Medical terminology
- Medical appeals handling
- Insurance verification
- Effective communication skills
- Data entry
- Medical terminology knowledge
- Benefit coverage
- Patient confidentiality compliance
- Records maintenance
Certification
- First Aid Certification
- Six Sigma White Belt Certification
Timeline
Prior Authorization Specialist
Carelon Global Solutions Inc.
04.2023 - 02.2025
Medical Prep Specialist
Carelon Global Solutions Inc.
04.2023 - 02.2025
Customer Service Representative
Carelon Global Solutions, Inc.
04.2023 - 02.2025
Technical Support Representative
Concentrix
12.2020 - 01.2023
Travel Staff
HIS Global Business Inc.
03.2019 - 03.2020
Outbound Sales Representative
BD BPO Solutions
08.2017 - 08.2018
Bachelor of Science - Business Administration And Management
Jose Rizal University
Associate - Midwifery
Iloilo Doctors' College
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