Hezel Fuertes

Customer support and healthcare operations professional with 4+ years of experience across payroll technical support, healthcare member services, and provider support. Proven track record resolving complex payroll, claims, and benefits issues while maintaining HIPAA compliance and high service-quality standards in fast-paced environments.

Provider Medical Support - Cognizant

(2025-04 - 2025-08)

Supported healthcare providers with claims, eligibility, benefits, prior authorizations, and payment inquiries, ensuring timely, accurate resolution.

• Investigated claim denials and underpayments, guiding providers on corrective documentation to improve claims accuracy.
• Maintained strict HIPAA compliance while educating providers on portal usage and documentation best practices.

Customer Medical Representative - Supportware

(2023-01 - 2024-12)

Assisted members with prescription coverage, prior authorizations, formularies, and medication denials, resolving cases efficiently.

• Partnered with healthcare teams and pharmacy benefit managers (PBMs) to resolve complex, multi-party cases.
• Managed urgent escalations under pressure while ensuring 100% HIPAA-compliant documentation.

Advisor II – QuickBooks Payroll Technical Support - Concentrix Montage

(2021-01 - 2023-12)

Delivered technical support for QuickBooks Payroll, troubleshooting paycheck errors, tax discrepancies, and processing issues.

• Maintained detailed resolution documentation to support quality assurance and continuous improvement.
• Consistently met or exceeded SLAs and quality targets while managing escalated payroll concerns.

Freelance Security Monitor - Storewell Storage

Monitored storage facilities during evening hours, reporting suspicious activity and ensuring property safety.

Marketing Assistant - Small Scale Business

Supported daily operations including inventory tracking, expense monitoring, and customer service.

Bachelor of Science - Tourism Management - University of Cebu – Banilad Campus (2021-01)