John Lester Buñales

Detail-oriented claims professional with experience in medical reimbursement claims, insurance claims, financial services, and customer operations. With hands-on experience as a Reimbursement & Claims Specialist at InLife Benefits and a Claims Specialist for JP Morgan Chase, I have developed expertise in claims adjudication, reimbursement processing, documentation review, data validation, policy compliance, and case management while ensuring accuracy and meeting service-level agreements. I'm reliable, adaptable, and thrive in roles that require attention to detail, confidentiality, and a strong sense of responsibility.

Reimbursement & Claims Specialist at InLife Benefits (2026-02 – 2026-07)

• Processed an average of 17–20 medical reimbursement claims daily, reviewing claim forms, official receipts, medical records, and policy provisions to determine claim eligibility while ensuring compliance with company policies, reimbursement guidelines, service-level agreements (SLAs), and turnaround times (TATs).
• Verified, analyzed, and maintained accurate claims data in the Medical Administration System (MAS) by validating diagnoses, medical procedures, consultations, prescribed medications, and supporting documentation, identifying discrepancies, and preparing complete claims for reimbursement approval.
• Managed end-to-end reimbursement case processing by following up on incomplete submissions, requesting additional documentation, responding to claimant inquiries via phone, email, and in person, and resolving pending cases within established service standards.
• Collaborated with healthcare providers and cross-functional teams to verify billing information, reconcile claim discrepancies, maintain organized electronic and physical claim records, and support accurate, compliant, and timely reimbursement processing.

Operations Customer Expert I (Telephone Banker & Claims Specialist) at JP Morgan Chase at Teleperformance Cebu (2025-01 – 2026-01)

• Functioned as a Telephone Banker, providing timely and accurate support to customers by addressing inquiries, managing account transactions, and thoroughly documenting complaints and claims for back-office review and investigation.
• Demonstrated expertise in disputing a wide range of fraudulent and non-fraudulent transactions, including debit card purchases, digital wallet activity, and online bill payments, ensuring proper resolution while protecting customers' financial interests.
• Consistently achieved top performance metrics, earning regular incentives for exceptional service quality, compliance, and perfect attendance, reflecting strong commitment and reliability.
• Managed high-volume call queues with an efficient average handle time of 360 seconds, successfully assisting over 1,200 customers per month, while maintaining professionalism, accuracy, and adherence to regulatory and company standards.

Freelance Gym Instructor at Spirit Gym (2023-10 – 2025-12)

• Provide one-on-one training sessions for 2-5 clients per month, dedicating an hour daily to each client's fitness needs, with a focus on customized exercise programs tailored to weight loss, muscle gain, competition preparation, or general wellness.
• Organize and monitor client training schedules, ensuring timely and effective delivery of personalized fitness programs to meet individual health goals.
• Develop personalized meal plans for each client, ensuring nutritional alignment with their fitness goals, and advise on optimal health supplements to support their progress and overall health.

Bachelor of Science in Marine Transportation – University of Cebu Maritime Education and Training Center (2019 – 2024)

Senior High School in General Academic Strand – Cathedral School of La Naval (2017 – 2019)