Emman Macaraig

I’m a healthcare customer advocate who delivers accurate, compliant, high-quality support across authorization processing, claims coordination, and provider communication. I focus on improving customer satisfaction while supporting long-term operational goals.

In prior roles, I helped verify whether prior authorization was required, supported submission and processing of prior authorization requests, and monitored authorization statuses to ensure continuity of patient care. I also communicated authorization decisions clearly and professionally to providers.

I’ve strengthened quality and performance through quality assurance work—coaching agents, monitoring key performance metrics, and ensuring compliance with internal quality standards and policies. I earned recognition as Resultcx Top QA Analyst for the PH Region (Q3, 2023), and later received “The Workflow Wizard” award for task completion and operational excellence.

Most recently, I manage insurance claims and case statuses by coordinating with network providers, verifying attendance, maintaining documentation in internal systems, and tracking authorization requests with adjusters and Nurse Case Managers. I also support escalations for complex cases and provide buddy mentoring for new hires.