Ray Recto

Results-driven professional with experience in customer service and executive support. Skilled in client communication, schedule coordination, problem-solving, and administrative operations. Proven ability to streamline workflows, support teams, and deliver excellent customer experiences.

Level 02 Member Services Representative - OPTUM (Global Solutions)

(2016-02 - 2018-05)

• Assisted healthcare providers in obtaining Prior Authorization, Provider Network Status and Member eligibility and benefits.
• Helped the company in maintaining good quality in providing assistance to clients and healthcare providers.

Subject Matter Expert and QA Specialist - WIPRO LTD

(2018-05 - 2022-07)

• Performed quality checks on complaints in a timely response, ensures quality and service deliverables are addressed properly per business requirements.
• Handled escalations and quality management.
• Worked as an SME for new joiners assisting real time staffing and product/process knowledge.

Medical VA - Auth-Net LLC

(2022-08 - 2023-11)

• Perform Insurance Verification, Eligibility and Benefits, Prior - Authorization and case reconsiderations by utilizing EMR/EHR softwares, Provider portals, fax and phone.
• Ensuring all PHI's are recorded and retrieved in accordance to the federal law (HIPAA).

Medical VA — Spanish Bilingual - Auth-Net LLC

(2023-11 - 2026-05)

• Perform Insurance Verification, Eligibility and Benefits, Prior - Authorization and case reconsiderations by utilizing EMR/EHR softwares, Provider portals, fax and phone.
• Outbound calls for Medical Appointment confirmation, reschedule and cancellation. Inbound calls for appointment schedules, general inquiry and medical refills.

Undergraduate - Business Administration, Operations Management