Carlo Fajardo
Prior Authorization Specialist
Marikina
Summary
Seeking for a Prior Authorization Specialist position in your reputable company for possible career development.
Overview
12
12
years of professional experience
Work History
Team Lead - Prior Authorization
Mochi Health
08.2023 - 08.2025
- Promoted a positive work environment by fostering teamwork, open communication..
- Enhanced overall team performance by providing regular coaching, feedback, and skill development opportunities.
- Established clear performance metrics for the team which helped in tracking progress towards set targets effectively.
- Submitting Prior Authorization Requests via CoverMyMeds, Promptpa, Insurance portals, and fax.
- Does scheduling and intake if needed.
Case Manager - SSA/DDS (Part Time)
Appaid
01.2025 - 07.2025
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
Senior Collections Associate – Conifer Health
NTT Data Services
12.2019 - 08.2023
- Account Receivables Management. Appeal Creation. Post Payment Audits: Ensuring all claim payments being made are in good order. Also, reaching out to the insurance to confirm eligibility and coverage of the patient.
Email/Chat Phone – CSR TSR BackOffice
TaskUs
02.2018 - 11.2019
- Technical Support Representative, Chat and Email Support: Providing assistance on any technical issue the customer has with their devices.
- Back office: Ensuring all the paperwork that the applicant submitted are legit and accurate.
Heath Advocate/ CSR
Optum Gobal Solutions
06.2016 - 01.2018
- Providing assistance on the patient/members benefit and coverage.
Technical Support Representative
Teleperformance
08.2015 - 05.2016
- Delivered exceptional customer service by quickly addressing concerns and providing clear, concise explanations of technical solutions.
- Improved customer satisfaction by providing timely and accurate technical support for various software and hardware issues.
Operations Associate/CSR
Sitel Philippines
08.2013 - 07.2015
- Oversaw daily operations, ensuring timely completion of tasks and adherence to company policies and procedures.
- Resolved customer issues promptly and professionally, maintaining high satisfaction rates while minimizing escalations.
Education
Bachelor of Arts - Psychology
Colegio De San Gabriel Arcangel
Philippines 05.2001 -
Skills
Leadership
Verbal and written communication
Staff training
Call center operations
Issue resolution
Quality improvement
Timeline
Case Manager - SSA/DDS (Part Time)
Appaid
01.2025 - 07.2025
Team Lead - Prior Authorization
Mochi Health
08.2023 - 08.2025
Senior Collections Associate – Conifer Health
NTT Data Services
12.2019 - 08.2023
Email/Chat Phone – CSR TSR BackOffice
TaskUs
02.2018 - 11.2019
Heath Advocate/ CSR
Optum Gobal Solutions
06.2016 - 01.2018
Technical Support Representative
Teleperformance
08.2015 - 05.2016
Operations Associate/CSR
Sitel Philippines
08.2013 - 07.2015
Bachelor of Arts - Psychology
Colegio De San Gabriel Arcangel
05.2001 -
Similar Profiles
Michael LosevMichael Losev
Founding Engineer at Mochi HealthFounding Engineer at Mochi Health
Jomar GonzalgoJomar Gonzalgo
Appointment Scheduler/Insurance Verification Specialist at Mochi HealthAppointment Scheduler/Insurance Verification Specialist at Mochi Health
TARA LARKINTARA LARKIN
Telehealth Physician at Mochi HealthTelehealth Physician at Mochi Health
EDMARIE TONELEDMARIE TONEL
Senior Manager, Global Service Centre at CBRE GWS IFM Phil Corp.Senior Manager, Global Service Centre at CBRE GWS IFM Phil Corp.
Lalaine Pilar PostLalaine Pilar Post
Customer Service Representative at IntouchCXCustomer Service Representative at IntouchCX