Madelyne Leila Gauna

• Verifies patient insurance eligibility and obtains necessary prior authorizations and reauthorizations to ensure uninterrupted care and prevent claim denials.
• Performs patient registration and accurately enters charges into EMR/EHR systems such as Office Ally, Prompt, and Tebra.
• Processes and submits over 150 medical claims weekly via payer portals including UHC, Availity, NaviNet, and Novitasphere for both private and public insurers like Aetna, Cigna, Medicare, Medicaid, etc.
• Monitors claim status and conducts regular accounts receivable (AR) follow-ups with insurance payers to expedite payments and reduce outstanding balances.
• Posts payments and collections promptly, updating patient records to maintain accurate financial documentation.
• Reviews denials and claim rejections, collaborates with medical coders to correct errors, and resubmits claims to reduce billing discrepancies by 20%.
• Maintains strict HIPAA compliance throughout all stages of the billing cycle, safeguarding sensitive patient information.
• Supports cross-functional teams by streamlining insurance verification, data entry, and billing workflows, improving departmental efficiency by 15%.
• Responds promptly to client and team inquiries, documents issue resolutions thoroughly, and ensures clear communication.

• Conducts needs-based consultations and insurance needs analysis to develop personalized financial planning and life insurance solutions, specializing in Traditional Life and VUL products tailored to client goals.
• Calculates and presents insurance quotes to over 100 prospective clients, recommending coverage aligned with their financial profiles, life stages, and risk appetite.
• Performs policy reviews, provides proactive after-sales service, and supports claims processing to ensure a seamless and supportive client experience.
• Builds and maintains lasting client relationships through professional financial guidance and promotes financial literacy via social media campaigns to increase engagement and brand visibility.
• Applies consultative sales techniques and consistently meets or exceeds monthly sales targets by tailoring solutions to client needs.
• Maintains a 100% client retention rate by delivering personalized policy reviews, claims assistance, and ongoing client support.
• Utilizes tools including PRUAccess Services, PRUOne, eQuotes, PRISM, Insurance Needs Analysis Tools, DocuSign, Google Workspace, and Canva for efficient client management and communication.

• Managed AT&T's small business telecommunications accounts by delivering personalized mobility, internet, and wireline service support, resolving billing disputes, and driving customer loyalty.
• Investigated complex billing issues through detailed analysis and achieved timely resolution while maintaining high compliance standards.
• Provided technical support by troubleshooting service issues using AT&T proprietary systems.
• Executed sales and marketing strategies by identifying upsell and cross-sell opportunities, increasing product adoption by 15%.
• Maintained accurate case documentation in Salesforce and client CRMs, ensuring 98% accuracy in reporting and compliance.
• Recommended workflow improvements that reduced call transfers by 10% and accelerated resolution times.
• Consistently achieved a 95% first call resolution rate and a CSAT score of 4.7/5, earning multiple Top Agent of the Month awards.

• Supported AT&T residential telecommunications customers by resolving billing issues, service disruptions, and sales inquiries with empathy and professionalism.
• Conducted personalized consultations to recommend plans, devices, and internet packages, boosting add-on sales and cross-sell conversions by 15%.
• Handled escalated calls effectively, achieving a 95% resolution success rate and strengthening customer retention.
• Maintained CSAT scores above 90% while managing high call volumes and sustaining quality service.
• Documented all interactions and case resolutions accurately in proprietary CRM systems to ensure compliance and data integrity.
• Educated customers on billing policies and service features, reducing repeat call rates by 20%.
• Recognized for professionalism, adaptability, and maintaining customer trust in high-pressure environments.

• Managed daily virtual assistant tasks including calendar management, inbox handling, bookkeeping, research, and data entry for YouSpeak Academy and other independent clients.
• Designed digital assets such as social media graphics, event posters, and marketing collateral using Canva, Adobe Illustrator, and Photoshop.
• Managed social media accounts across Facebook, Instagram, TikTok, LinkedIn, and other platforms, handling content planning, caption writing, scheduling, and analytics to boost client visibility and engagement by over 40%.
• Assisted clients with content editing, prop creation, graphic design, and branding tools development.
• Collaborated effectively with clients via Trello, Asana, and Google Workspace to manage projects, revisions, and approvals.
• Streamlined administrative processes, reducing turnaround time by 25% through improved scheduling, file organization, and documentation.
• Earned consistent recognition for reliability, creativity, and client satisfaction across multiple projects.

Consistent Campus President's Lister

Completed one years of BA in Political Economy

Senior High School Majoring Accounting, Business, & Management (ABM)

Junior High School with Special Science Curriculum