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Bianca B. — Senior Healthcare Operations Leader from Philippines

Bianca B.

Senior Healthcare Operations Leader

Philippines 3-6 years
Open to offersNew to Platform
Languages
EnglishTagalog
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About

Bianca M. is a dedicated operations leader in the healthcare industry, specializing in health insurance customer service within BPO environments. With over five years of experience, she has excelled in managing team performance, specifically focusing on key metrics and providing comprehensive mentoring to new employees. At Carelon Global Solutions, she serves as an Assistant Manager, where she leads a team of referral specialists, ensuring daily operations meet and exceed performance goals. Her role includes monitoring team output and serving as a key escalation point for process issues. Previously, she has worked as a Subject Matter Expert and a Referral Specialist, acquiring expertise in pre-authorization processing and benefits verification. Her career began at The Results Companies, where she improved customer satisfaction through effective customer service techniques. Bianca holds a Bachelor of Science in Business Administration from the University of the East, demonstrating a strong foundation in business management principles.

Experience

  • Assistant Manager

    Carelon Global Solutions · 2023 — Present
    Oversee daily operations for a team of referral specialists, ensuring performance goals and metrics are met consistently. Monitor team and individual performance, offering coaching and feedback for ongoing improvement. Act as an escalation point for complex referral and process issues to guarantee timely resolutions.
  • Subject Matter Expert

    Carelon Global Solutions · 2021 — 2023
    Address associate inquiries regarding processes and procedures in real time through MS Teams chat support to minimize errors and downtime. Provide mentoring and cross-training for newly hired associates to enhance onboarding and adherence to processes.
  • Referral Specialist

    Carelon Global Solutions · 2021 — 2021
    Initiate clinical referrals for pre-authorization in line with health plan guidelines and turnaround requirements. Process inbound calls to begin exam requests following established clinical and administrative protocols.
  • Health Care Customer Service Representative

    The Results Companies · 2020 — 2021
    Educate members on their health insurance coverage details to enhance understanding and satisfaction. Process pre-authorizations for medical treatment in compliance with plan and provider guidelines. Advise members on co-payment structures and suitable plans based on individual needs.
  • Technical Support Representative

    IBEX Global Philippines · 2019 — 2020
    Assist customers with troubleshooting basic hardware, external software, and network connectivity issues. Attain a high first-contact resolution rate through rapid acquisition of detailed product knowledge.

Skills & Expertise

Education

  • Bachelor of Science in Business Administration, Major in Business Management
    University of the East · 2016 — 2019
  • High School Diploma
    San Bartolome High School · 2013 — 2015

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