I am looking for remote voice/non-voice work supporting healthcare providers with plan inquiries, eligibility checks, and benefit explanations. I resolve claims status, documentation issues, and policy updates with high accuracy. I coordinate with internal teams to close billing discrepancies and maintain strict confidentiality standards for PHI and sensitive records.
KGLooking for a job
Kate Llensey Gumaha
@katellenseygumaha
Provider Relations & Claims Resolution Specialist
PhilippinesWhat I'm looking for
Cambia Health Solutions (Provider Relations & Claims Resolution Specialist)
Managed complex plan inquiries, eligibility verifications, and benefit explanations to support healthcare providers through non-sales channels.
Resolved claims status inquiries, rectified documentation discrepancies, and communicated policy updates with strict attention to accuracy.
Collaborated cross-functionally with internal departments to investigate and efficiently close billing and eligibility discrepancies.
Upheld strict confidentiality standards for Protected Health Information (PHI) and sensitive medical records.
L1 Telephones Company (Outbound Telephone Research Agent)
Delivered structured, professional communication services while managing high-volume inbound and outbound call queues.
Executed targeted peer-to-peer texting and emailing campaigns, successfully driving key performance indicators (KPIs) for clients.
Maintained audit-ready interaction records and executed project-based data entry within designated CRM platforms.
Tracked active workflow and call times utilizing Callshaper reports to ensure maximum operational efficiency.
Experience
Work history, roles, and key accomplishments
CSSupported healthcare providers with plan inquiries, eligibility checks, and benefit explanations via non-sales channels. Resolved claims status, documentation issues, and policy updates with high accuracy. Coordinated with internal departments to close billing and eligibility discrepancies efficiently while maintaining strict confidentiality standards for PHI and sensitive medical records.
TC
Customer Support Specialist
Telephones Company
Aug 2020 - Dec 2024 (4 years 4 months)
Handled structured inbound and outbound call and chat-based communications, including interview-completion support, while maintaining HIPAA-aligned process adherence and confidentiality. Managed workflow and call-time tracking in CRM tools and supported outbound research/marketing survey campaigns with accurate administrative data entry.
Education
Degrees, certifications, and relevant coursework
NCNotre Dame of Kidapawan College
Bachelor of Secondary Education, English (Major)
Earned a Bachelor of Secondary Education with a Major in English from Notre Dame of Kidapawan College, building strong communication and instructional foundations for client interactions.
Tech stack
Software and tools used professionally
Availability
Looking for a job
Location
PhilippinesAuthorized to work in
Salary expectations
645k-753k USD
Job categories
Skills
Provider RelationsEligibility VerificationDocumentation DiscrepanciesDocumentation ManagementEmail SupportChat SupportFaxData EntryProcess AdherenceCompliance SupportCRM ManagementSalesforceHubSpotRADAR (EHR EMR Ready Tracker)EHRInContactCallshaperSDSBlueweb B2Microsoft TeamsOutlookGoogle WorkspaceMicrosoft Office 365TelephoneRoutingIntake CoordinatorGenesysGmail RemoteAvaility Essentials
Interested in hiring Kate Llensey?
You can contact Kate Llensey and 90k+ other talented remote workers on Himalayas.
Message Kate LlenseyFind your dream job
Sign up now and join over 100,000 remote workers who receive personalized job alerts, curated job matches, and more for free!
