Edilberto N.

I began my career in 2019 in the BPO industry as a Customer Service Representative, handling inbound and outbound support for a UK-based food delivery account. I later transitioned into a multi-channel role, supporting customers via calls, email, and chat, which helped me build strong communication, problem-solving, and customer experience skills. Through consistent performance and attention to quality, I was promoted to Quality Analyst within a year. In this role, I audited calls, emails, and chats, provided coaching and actionable feedback, and contributed to improving overall team performance. I also handled reporting, including QA scores, performance insights, and process improvements. After my experience as a Quality Analyst, I transitioned into US-based healthcare accounts to gain more hands-on experience in operations and insurance processes. I worked as a Customer Service Representative and was later promoted to Senior Process Executive, where I handled more complex and critical tasks. In this role, I managed inbound and outbound calls, handled email communications, forwarded medical records to providers when needed, checked authorization status, and monitored overall claims workflow. This experience allowed me to develop a deeper understanding of healthcare processes, insurance coordination, and end-to-end case handling. Currently, I work as a Medical Virtual Assistant specializing in pre-authorization for procedures and medications, as well as eligibility and benefits verification for US healthcare accounts. I support clinic managers, medical assistants, and physicians by handling administrative tasks, answering inquiries, and ensuring smooth coordination with insurance providers. I also assist with financial consultations by providing patient cost estimates for treatments and procedures. I have hands-on experience in the infertility field, managing prior authorizations, treatment benefit verification, and patient insurance coordination on a daily basis. I am highly experienced in using multiple tools and submission methods, including fax and insurance portals such as Availity, UHC, Evicore, Carelon, and more. I have worked extensively with insurance providers like BCBS, Aetna, UnitedHealthcare, UMR, Baylor Scott & White, as well as pharmacy platforms like CoverMyMeds and Alto Pharmacy. I am reliable, detail-oriented, and highly resourceful. I work independently, take initiative, and consistently find ways to complete tasks efficiently and accurately. I adapt quickly to new systems and workflows, making me a versatile and dependable support partner for any healthcare or administrative team.