Senior Customer Service and Healthcare Operations Leader with over 10 years of experience leading high-performing teams in healthcare insurance and customer support. Proven expertise in team leadership, workforce management, quality assurance, training, coaching, performance reporting, and process improvement.
Senior Team Lead – Healthcare Operations (Cigna Account)
Convergys Philippines
April 2021 – July 2025
♦ Led the day-to-day operations of a healthcare insurance support team handling medical claims, eligibility verification, prior authorizations, and member/provider inquiries.
♦ Managed team performance through coaching, quality assurance, workforce management, KPI monitoring, and performance reviews to consistently achieve operational goals.
♦ Spearheaded process improvement initiatives that streamlined workflows, reduced processing errors, improved turnaround times, and enhanced the overall customer experience.
Identified operational bottlenecks through data analysis and collaborated with cross-functional teams to implement sustainable process improvements.
♦ Developed and standardized Standard Operating Procedures (SOPs), best practices, and quality guidelines to improve consistency, compliance, and operational efficiency.
♦ Created operational reports, KPI dashboards, and performance analyses using Microsoft Excel, enabling data-driven decision-making and leadership reporting.
♦ Utilized Salesforce CRM to manage customer cases, monitor escalations, track performance, and ensure timely issue resolution.
♦ Partnered with Training, Quality Assurance, and Operations teams to implement continuous improvement initiatives that increased productivity and quality performance.
♦ Conducted root cause analysis on recurring issues and developed corrective action plans to improve team performance and customer satisfaction.
♦ Mentored Team Leaders and Subject Matter Experts, supporting leadership development and succession planning.
♦ Ensured compliance with HIPAA regulations, client policies, and service level agreements (SLAs).
♦ Supported organizational change initiatives by driving the adoption of new processes, tools, and operational best practices.
Training & Quality Team Leader (Cigna Account)
Convergys Philippines
October 2017 – April 2021
♦ Led the Training and Quality team responsible for onboarding, coaching, and developing customer service representatives.
♦ Conducted quality audits, calibration sessions, and performance reviews to improve service delivery.
♦ Designed and facilitated training programs that increased quality scores, productivity, and employee performance.
♦ Analyzed quality trends and implemented corrective action plans to address performance gaps.
♦ Developed reports, tracked KPIs, and identified opportunities for improvement using Microsoft Excel.
♦ Collaborated with Operations leadership to enhance customer experience and drive continuous improvement initiatives.
Team Leader (Cigna Account)
Convergys Philippines
2012 – 2017
♦ Supervised a team of customer service representatives, ensuring achievement of quality, productivity, attendance, and customer satisfaction targets.
♦ Conducted coaching sessions, performance evaluations, and one-on-one development meetings.
♦ Managed workforce distribution and provided real-time operational support to maintain service levels.
♦ Handled customer escalations and partnered with cross-functional teams to resolve complex issues.
♦ Prepared team performance reports, analyzed trends, and developed action plans using Microsoft Excel.
♦ Supported onboarding, mentoring, and continuous learning initiatives for new tea-----------mbers.
Customer Service Representative (Cigna Account)
Convergys Philippines
2010 – 2012
♦ Assisted members with healthcare insurance inquiries, including benefits, eligibility verification, medical claims, and prior authorizations.
♦ Delivered exceptional customer service while consistently meeting quality, productivity, and customer satisfaction goals.
♦ Documented customer interactions, managed cases, and maintained accurate records using Salesforce CRM.
Resolved customer concerns efficiently while ensuring compliance with healthcare policies and HIPAA regulations.
Built strong product knowledge and established a reputation for professionalism, accuracy, and customer-focused service.
