Mabel Bianes
Silang, Province Of Cavite,CAV
Summary
Dynamic Customer Service Representative excelling in problem-solving and active listening. Enhanced customer loyalty through empathetic complaint resolution and increased first-call resolutions. Adopt a navigating complex insurance processes, fostering strong provider relationships, and ensuring seamless claims processing.
Overview
12
12
years of professional experience
Work History
Customer Service Representative
Valmed Home Health Solutions
04.2025 - 10.2025
- Making outbound calls to all patients who requested that their medical equipment be picked up.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Customer Service Representative
DME Service Solution
09.2023 - 02.2025
- Sending emails to case managers follows prior authorization.
- Check the member's eligibility for insurance coverage.
- Checked the claim denial reason.
- Submit a request to a specific payer regarding the purchase of medical equipment.
- Review billing guidelines per insurance.
Provider Service Advocate
Wipro
03.2019 - 09.2023
- Worked effectively in providing healthcare insurance coverage.
- Maintained detailed knowledge about claims processing, denials, appeals, and prior authorization.
- Increased first-call resolutions by employing effective problem-solving strategies tailored to each unique situation.
- Managed high call volumes while maintaining quality service standards and positive customer interactions.
- Assisted in training new employees, sharing best practices for achieving success as a Service Advocate.
Customer Service Representative
Hinduja Global Solutions
07.2018 - 03.2019
- Handled inbound calls to all Healthcare Providers inquiring certain coverage.
- Provide different claim statuses.
Provider Services Representative
Concentrix
02.2014 - 06.2018
- Facilitated smoother claims processing by rigorously verifying provider information.
- Promoted positive relationships between the organization and its network providers through timely responses to inquiries and effective issue resolution about insurance benefits.
- Fostered strong relationships with healthcare providers, leading to higher retention rates.
Education
Bachelor of Science - HOTEL , RESORT AND RESTAURANT MANAGEMENT
EASTERN SAMAR STATE UNIVERSITY
EASTERN SAMAR03-2013
High School Diploma -
SAMAR NATIONAL PILOT
EASTERN SAMAR06-2008
Skills
- Customer service
- Problem-solving
- Active listening
- Adaptability and flexibility
Timeline
Customer Service Representative
Valmed Home Health Solutions
04.2025 - 10.2025
Customer Service Representative
DME Service Solution
09.2023 - 02.2025
Provider Service Advocate
Wipro
03.2019 - 09.2023
Customer Service Representative
Hinduja Global Solutions
07.2018 - 03.2019
Provider Services Representative
Concentrix
02.2014 - 06.2018
Bachelor of Science - HOTEL , RESORT AND RESTAURANT MANAGEMENT
EASTERN SAMAR STATE UNIVERSITY
High School Diploma -
SAMAR NATIONAL PILOT
Character References
Anna Alvarez
HR Manager, VALMED
09420274023
EZRA MAE GAGARIN
QUALITY Analyst at WIPRO
09456108790
HOBBIES
Watching Netflix , Reading and Planting.