Marc Genesis Reabal

Detail-oriented Healthcare Operations & Quality Analyst with over 3 years of experience in US Healthcare and Revenue Cycle Management (RCM). Expert in both Front-End (Insurance Verification/Authorization) and Back-End (Quality Auditing/Compliance) workflows. Leveraged technical background in IT to streamline digital workflows and improve RCM data accuracy within healthcare platforms.

Quality Analyst at Med-Metrix (2025-05 – Present)

• Quality Auditing: Developed Quality Parameters for 100% audit coverage, ensuring strict adherence to HIPAA regulations and Standard Operating Procedure.
• Process Optimization: Architected a comprehensive Standard Operating Procedure (SOP) Playbook, standardizing workflows across two major accounts to reduce onboarding time and human error.
• Data-Driven Trends & Allocation: Partnered with Operations management to analyze quality gaps, co-designing workflow game plans and task allocation strategies that boosted overall team productivity by 15%.
• Crisis Management & Account Stabilization: Intervened during an unexpected team leadership transition to stabilize a critical healthcare account, successfully mitigating client escalations and resolving severe productivity bottlenecks.
• Cross-Functional Training Support: Addressed critical training department staffing shortages by independently facilitating technical onboarding and compliance training for incoming authorization agents.
• Operational Stabilization (Special Assignment): Intervened during an unexpected leadership transition to manage end-to-end pending case inventories via bi-daily Excel tracking, successfully mitigating account escalations and stabilizing backlogs.

Authorization Representative (The Brooklyn Hospital Center) at Med-Metrix (2024-08 – 2025-04)

• Revenue Protection: Secured patient revenue by accurately verifying insurance eligibility and obtaining prior authorizations via web portals and direct payer communication.
• Billing Accuracy: Ensured Coordination of Benefits (COB) and updated financial classes to ensure clean claim submission and reduce denials.
• High Performance: Consistently maintained a 120% productivity rate, exceeding daily quotas while improving the patient intake experience.

Customer Service Representative (Humana) at Sagility (2022-08 – 2024-03)

• Issue Resolution: Leveraged CRM tools to manage complex insurance policy inquiries, optimizing follow-up efficiency for benefit verification and claims adjudication.
• Data Integrity & Privacy: Upheld 100% compliance with HIPAA and PHI regulations while managing confidential patient and provider data within high-volume databases.
• Service Excellence: Streamlined high-volume call workflows, maintaining a 80%+ positive satisfaction rating during peak periods.
• Performance Recognition: Awarded "Top Agent of the Month" for exceptional service quality, achieving a cumulative satisfaction rating of 81.48% based on 54 unique positive survey contributions.

BS in Information Technology – Quezon City University (2018 – 2022)