Senior Benefits Analyst at Carelon Global Solutions Philippines (2024-01 – 2026-06)
- Quality Auditor – audit medical contract codes (New Group, Renewals, and Change Requests) for our US, India, and Philippines Benefit coding team before sending them to production.
- Creates comprehensive error summary reports for the Quality Team, identifying trends to drive continuous process improvements.
Benefit Analyst at Accenture Inc. (2013-06 – 2023-12)
- Configured and provisioned unique contract codes for client health benefit plans, ensuring seamless system architecture and alignment with plan designs.
- Created Benefit Summaries or Benefit Plan Designs for our clients
- Configured medical benefits, Utilization Management (UM) protocols, and pharmacy benefit structures within the system applications to automate claim accuracy.
- Assigned Healthcare Common Procedure Coding System (HCPCS) codes to medical contract configurations to ensure accurate claim adjudication and billing alignment.
- Create variations and attaching lookalikes, ensuring that the adjudication system recognizes and processes medical claims without manual intervention
- Conducted comprehensive peer reviews for onshore/offshore, providing actionable feedback to reduce error rates and foster continuous learning across onshore and offshore analysts.
- Acted as SME and provided region-based support depending on business needs.
- Provides mentorship and technical trainings to new analysts to ensure quality performance
IT Support (OJT) at Kudo Support, Inc. (2011-11 – 2012-03)
- Partnered with IT technicians to diagnose and resolve PC hardware and software issues.
- Assisted in network cabling installations and infrastructure setup.
