Lajot, Joan N.
Infinitus AI- Insurance Verification Specialist (CSR III)
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About
Customer service professional with expertise in healthcare administration, insurance verification, and claims processing. Skilled in ensuring accuracy, compliance, and delivering high-quality service in fast-paced environments.
Experience
Infinitus AI- Insurance Verification Specialist (CSR III) - TELETECH DUMAGUETE - Dumaguete City
(2024-06 - 2024-03)
- Skilled in verifying patient insurance coverage, benefits eligibility, and prior authorizations for medical services.
- Adept at navigating major insurance portals and interpreting complex policy details to ensure accurate billing and compliance with HIPAA regulations.
- Strong multitasking and problem-solving skills with a commitment to delivering exceptional customer service and maintaining data integrity in fast-paced environments.
Blue Cross Blue Shield of New Jersey (CSR II Member Services) - QUALFON DUMAGUETE - Dumaguete City
(2025-09 - 2025-03)
- Experienced Member Services Representative with a strong background in healthcare administration, specializing in claims processing, eligibility verification, benefits coordination, and appeals management for Blue Cross Blue Shield of New Jersey.
- Skilled in delivering exceptional customer service, analyzing claim discrepancies, and facilitating timely resolutions to enhance member satisfaction.
- Proven ability to communicate effectively with members, providers, and internal teams to maintain high standards of service and operational excellence.
HMA Intake Specialist (Senior Process Executive) - COGNIZANT DUMAGUETE - Dumaguete City
(2025-04 - 2025-06)
- Processed prior authorization requests for U.S. healthcare providers through voice and non-voice channels.
- Verified insurance eligibility, benefits, and prior authorization requirements.
- Reviewed and compiled medical records to ensure accurate authorization submissions.
- Coordinated with providers and insurance companies to obtain required documentation and authorization updates.
- Maintained accurate records while ensuring HIPAA compliance and timely case processing.
Education
Bachelor of Science in Education - Education - Negros Oriental State University (2024 - 2025)
