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John Paul Llena

@johnpaulllena

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Healthcare operations specialist with 7+ years in claims review, quality auditing, and Excel reporting.

Philippines

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What I'm looking for

I am seeking a role in healthcare operations or claims quality where I can apply my expertise in claims review, Excel-based reporting, compliance, and process improvement while contributing to a collaborative, client-focused team.

I am a detail-oriented healthcare operations professional with over seven years of experience supporting medical claims processing, quality auditing, and insurance operations for global organizations. I have a proven record of identifying discrepancies, ensuring SOP and regulatory compliance, and collaborating with cross-functional teams to improve accuracy, turnaround time, and client satisfaction.

I excel in Excel-based reporting and data validation, have led operations support and coaching initiatives, and contributed to client reporting and compliance activities such as Form 5500 filings. My background spans transaction processing, audit, training, process improvement, and manual testing for healthcare insurance systems.

Experience

Work history, roles, and key accomplishments

Manual Tester

Atos Syntel / Eviden

Feb 2022 - Nov 2025 (3 years 9 months)

Created test plans, RTMs and functional test scenarios for healthcare insurance software, validated requirements against designs, and executed tests to ensure reliable performance and requirement coverage.

Manual Testing Test Planning Requirements Traceability Matrix Testing Design Functional Testing Prioritization Documentation

Analyst, Client Operations

Willis Towers Watson

Mar 2021 - Oct 2021 (7 months)

Supported healthcare benefits administration including policy verification, client and carrier reporting, Form 5500 contributions, and data analysis to ensure compliance and inform client decisions.

Benefits Administration Data Analysis Benchmarking Compliance Excel

Operations Support Team Lead

Accenture

Jan 2020 - Mar 2021 (1 year 2 months)

Led operations support for large-dollar healthcare claims, monitored performance metrics, coached advocates, investigated discrepancies, and implemented process improvements to boost quality and productivity.

Team Leadership Claims Processing Performance Monitoring Coaching Process Improvement Compliance

Quality Auditing Associate

Accenture

Jan 2017 - Jan 2019 (2 years)

Audited finalized healthcare claims and documents to ensure client quality standards, analyzed root causes of errors, and delivered actionable feedback and training to improve claims accuracy.

Root Cause Analysis Training Reporting Compliance Excel

Transaction Processing Associate

Accenture

Jan 2015 - Jan 2017 (2 years)

Processed and reviewed healthcare transactions with high accuracy against SOPs, performing data validation and discrepancy resolution to reduce processing errors and improve turnaround time.

Data Validation Pivot Tables Quality Assurance Documentation Research Error Resolution

Education

Degrees, certifications, and relevant coursework

National College of Business and Arts - Fairview

Bachelor of Science in Business Administration, Financial Management

2011 - 2015

Completed a Bachelor of Science in Business Administration with a concentration in Financial Management, focusing on financial principles and business operations.