Ryan Mainit

Representative with nearly four years of experience supporting U.S. healthcare and retail clients. Excellent expertise in Pharmacy Benefits Management (PBM), verification refills, formulary navigation, and prior authorizations, alongside strong foundational experience in provider network verifications and claims assistance. Highly skilled in maintaining strict HIPAA compliance and protecting data confidentiality.

Recognized for delivering accurate, efficient, and empathetic care while consistently exceeding CSM, CSAT, QA, and NPS performance standards.

Customer Service Representative (Retail) - CONCENTRIX PHILIPPINES - Pasig City

(2024-11)

• Managed customer orders, tracking, and account inquiries.
• Processed refunds and replacements for order issues.
• Resolved delivery concerns and order discrepancies.
• Assisted customers with product information and purchases.
• Applied promotional offers and discount codes when appropriate.
• Delivered excellent customer service while meeting performance goals.

Customer Service Representative (Healthcare) - CONCENTRIX PHILIPPINES - Pasig City

(2023-08 - 2024-09)

• Assisted members and healthcare providers with pharmacy benefits, formulary navigation, and prescription inquiries.
• Processed medication refills, over-the-counter (OTC) orders, and basic prior authorization routing.
• Tracked prescription delivery timelines, mail-order logistics, and order status updates.
• Educated members on plan coverage, copays, deductibles, and available healthcare services.
• Ensured strict HIPAA compliance, safeguarding protected health information (PHI) at all times.
• Consistently achieved high Net Promoter Score (NPS) and Customer Satisfaction (CSAT) targets.

Customer Service Representative (Healthcare) - TELEPERFORMANCE - Mandaluyong

(2022-10 - 2023-08)

• Assisted Blue Cross Blue Shield members and medical providers with comprehensive healthcare inquiries.
• Verified member eligibility, medical benefits, and insurance coverage details. Processed Durable Medical Equipment (DME) requests and routed Prior Authorization forms.
• Resolved complex claims related concerns and clearly explained medical plan details to members.
• Maintained thorough and accurate documentation in compliance with HIPAA guidelines.
• Consistently met or exceeded all Quality Assurance (QA) and CSAT performance goals.

Bachelor of Science - Major in Customs Administration - PHILIPPINE MARITIME INSTITUTE (2001)