RACHEL AGUILA
San Jose Del Monte
Summary
Dynamic customer service and technical support professional with over 15 years of extensive experience in the BPO industry, specializing in healthcare support, claims processing, and broadcast operations. Proven ability to resolve complex client issues, manage medical denials and appeals, and ensure compliance with industry regulations. Expertise in system troubleshooting, live stream monitoring, and performance validation, complemented by strong communication skills and meticulous attention to detail. Recognized for dependability, adaptability, and a steadfast commitment to delivering high-quality service and operational excellence in both independent and collaborative settings.
Overview
15
15
years of professional experience
Work History
Senior Process Executive
Cognizant Technology Solutions
05.2023 - 05.2025
- Monitoring Live Airings
- Performing necessary adjustments for accurate streaming
- Validating errors from system generated bugs.
- Ensured that performance parameters were met and exceeded within company's guidelines and policies.
- Ensured all queries were addressed so that client relationships were maintained.
- Successfully managed, coordinated and regulated all processes within operations.
Health Care Specialist (Provider Line)
Concentrix formerly Convergys Phil
04.2017 - 05.2023
- Denials and Appeals Specialist
- Claims Analyst
- Enforced basic rules and regulations to maintain discipline and minimise misconduct.
- Explaining Medical Claims to providers and providing accurate status.
- Maintained accurate documentation to meet programme requirements and contractual obligations.
- Collected evidence through investigations, verified documentation from claim submissions and opened new cases in company systems to initiate claim processing activities.
- Proofread records for completeness, accuracy and compliance with regulations.
- Prepared for medical auditing activities to maintain administrative compliance.
Customer Service Associate for Triple Play to Sales
TelePhilppines Incorporated
12.2016 - 03.2017
- Receives inquiries thru inbound and responds to customer
- Build customer's interest in the service in product offered by the company
- Make outbound calls for follow up customer support
- Retaining Customer by pitching Sales.
Technical Support for a Triple Play Inbound Support
Convergys Phil Services
06.2016 - 12.2016
- Receives inquiries thru inbound and responds to customer
- Build customer's interest in the service in product offered by the company
- Make outbound calls for follow up customer support
- Troubleshooting for Internet and Cables / Booking technician appointment.
Technical Support for a Triple Play Chat Support
Afni Inc
07.2015 - 05.2016
- Receives inquiries thru chat and responds to customer
- Build customer's interest in the service in product offered by the company
- Make outbound calls for follow up customer support
- Troubleshooting for Internet and Cables / Booking technician appointment.
Customer Care Specialist
Accenture Inc.
01.2014 - 07.2015
- Receives Inbound calls and responds to customer call and email inquiries
- Build customer's interest in the service in product offered by the company
- Make outbound calls for follow up inquires and updates given to customer.
Customer Service Assistant / Banquet Sales Assistant
Max's Restaurant
01.2010 - 01.2013
- Handles customer's concern and questions
- Booking Customers for Parties and Events
- Taking orders and assisting customers.
Education
Bachelor of Science in Accountancy, TERTIARY - June 2009 - March 2011
Polytechnic University of The Philippines
03-2011
SECONDARY - June 2005 - March 2009
Francisco Homes College
03-2009
Skills
- Strong focus on accuracy and privacy
- Medical Claims Analysis & Denials Management
- HIPAA Compliance & Documentation
- Quality Assurance & Performance Monitoring
- Compliant Handling & Communication Skills
- Time Management & Multitasking
- Healthcare Billing & Insurance Knowledge
- System Troubleshooting & Error Resolution
- Provider & Customer Support
- Records Management & Audit Preparation
Personal Information
References
Available upon request
Timeline
Senior Process Executive
Cognizant Technology Solutions
05.2023 - 05.2025
Health Care Specialist (Provider Line)
Concentrix formerly Convergys Phil
04.2017 - 05.2023
Customer Service Associate for Triple Play to Sales
TelePhilppines Incorporated
12.2016 - 03.2017
Technical Support for a Triple Play Inbound Support
Convergys Phil Services
06.2016 - 12.2016
Technical Support for a Triple Play Chat Support
Afni Inc
07.2015 - 05.2016
Customer Care Specialist
Accenture Inc.
01.2014 - 07.2015
Customer Service Assistant / Banquet Sales Assistant
Max's Restaurant
01.2010 - 01.2013
Bachelor of Science in Accountancy, TERTIARY - June 2009 - March 2011
Polytechnic University of The Philippines
SECONDARY - June 2005 - March 2009
Francisco Homes College
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