Mark Edren Toledo

Healthcare Customer Service and Dental Claims Specialist with 3+ years of experience supporting U.S. healthcare and dental accounts, specializing in dental claims and prior authorization processing, benefits and eligibility verification, appeals, provider network verification, and credentialing support. Experienced in handling provider inquiries and healthcare account support while maintaining accuracy, professionalism, and a high level of customer service.

Customer Service Advocate at Concentrix Philippines (2022 – 2026)

• Assist providers with Benefit and Eligibility breakdown for their patient’s Dental plan.
• Check Claims and Prior Authorization status, provide and explain claim denial, submit request for reprocessing and reconsideration.
• File Dental appeals, check appeal status and sending of resolution correspondence to Dental offices via fax and email.
• Support providers through credentialing proces, CAQH application, checking of provider network status and submit requests for provider fee adjustment.
• Sending EOB/EOP to provider office.

Bachelor of Arts in Political Science – Bicol University - College of Social Sciences and Philosophy (2014)