Jl Coquia

Achieved 94%+ first-contact resolution while handling claims inquiries and documenting outcomes accurately. Handled 50+ inbound calls/day, including 40+ claims-related calls, while maintaining sub-450-second average handle time. Verified insurance eligibility and benefits for 3,000+ quarterly patient inquiries with 98% accuracy, confirming coverage dates, plan limits, and authorization status across multiple payer systems.

Healthcare Customer Service Specialist (RCM Support) at Sagility (2023-09 – 2026-07)

• Achieved 94%+ first-contact resolution while handling claims inquiries and documenting outcomes accurately.
• Handled 50+ inbound calls/day, including 40+ claims-related calls, while maintaining sub-450-second average handle time.
• Verified insurance eligibility and benefits for 3,000+ quarterly patient inquiries with 98% accuracy, confirming coverage dates, plan limits, and authorization status across multiple payer systems.
• Investigated and resolved 500+ denied claims quarterly through systematic root-cause analysis of coding errors, timely filing issues, and payer rule failures, recovering $150K+ in previously denied revenue.
• Pre-processed 2,000+ monthly claims for submission readiness, identifying and resolving 92% of authorization gaps and coding discrepancies prior to provider queue release.
• Managed prior authorization and referral status inquiries, confirmed active approvals, and flagged expired or incomplete cases for resubmission.
• Tracked appeal status updates, monitored payer review progress, communicated resolutions, and maintained accurate documentation while working remotely for 2+ years.

Bachelor of Science in Mathematics – Pangasinan State University (2022-08)