ELBRAIN MACASILJIG
Newark
Summary
Healthcare expert with extensive experience and a strong foundation in data analysis and provider interactions. By June 2025, a Graduate Certificate in Artificial Intelligence and Business Analytics should be completed, enabling the use of advanced analytics in healthcare decision-making.
Overview
11
11
years of professional experience
Work History
Provider Relations Rep III
Alameda Alliance for Health
Alameda
04.2024 - Current
- Providing timely training per Alliance and state requirements and orientations for providers and their office staff for new providers, upon request from an office, or as needed to introduce new programs, provide ongoing education, or new policies and procedures.
- Effectively identifying, directing, and/or researching provider operational issues for timely resolution per Alliance and state requirements through a thorough knowledge of all areas of Alliance operations.
- Recruiting both new providers for participation in the Alliance network and existing providers for new lines of business and/or projects.
- Reporting from databases and other resources to provide information about the network to internal and external customers.
- Knowledge in Healthcare operations and processes like Claims, complex payments, authorizations, network management, compliance & regulatory knowledge, and provider support.
Member Services Rep I - Bilingual
Alameda Alliance for Health
Alameda
08.2021 - 04.2024
- Receive, manage, and document telephone calls, emails, and other sources of contact from members, potential members, and providers, and explain health plan benefits and plan rules.
- Provide clarification about issues regarding patient and physician rights and how the plan operates.
- Identify claim disputes by gathering members bill and file to grievance and appeal department.
Operations Assistant/Sales Rep
Verizon Cellular Sales
01.2020 - 08.2021
- Responsible for trade-in, returns, and aging phones and accessories in North Bay California.
- Operates in all North Bay stores with FIFO, Extra Tags, and Count Sheets.
- Develop continuous and up-to-date knowledge of Verizon Wireless and wireless products/services.
Sales Consultant
AT&T
08.2018 - 10.2019
- Develop and attain customer experience and sales objectives.
- Sell all products and services offered by the company.
Integrated Sales and Support
Foxit Software
03.2017 - 07.2017
- Attract potential customers by answering product and service questions.
- Enter orders into the sales system.
- Prepares product and service reports by collecting and analyzing data customer information.
- Communicate well and quickly through chat messaging, emails, support tickets and phones.
Technical Team Leader
Infinit-O Manila, Inc.
10.2015 - 12.2015
- Create new and modify existing processes of the account/LOB.
- Guide team to deliver good responses to customers, users and clients using Salesforce.
- Handle weekly/monthly team meetings.
Team Leader
Concentrix
06.2014 - 10.2015
- Team management.
- Monitored calls, metrics, provide feedback, coaching and data reporting.
Education
Graduate Certificate - ARTIFICIAL INTELLIGENCE AND BUSINESS ANALYTICS
DEVRY UNIVERSITY
Newark06.2025
MASTERS - BUSINESS ADMINISTRATION WITH CONCENTRATION IN INFORMATION SYSTEMS
DEVRY UNIVERSITY - KELLER GRADUATE SCHOOL OF MANAGEMENT
NEWARK08.2019
BACHELOR OF SCIENCE - COMPUTER SCIENCE
ASIAN COLLEGE OF SCIENCE & TECHNOLOGY
PHILIPPINES04.2010
Skills
- Data Analysis and Reporting
- Communication Skills
- Analytical Skills
- Problem-Solving and Decision-Making
- Industry Knowledge
- Operational Healthcare
- Business/Process Analysis
- Attention to Detail
- Conflict Resolution
- Teamwork and Collaboration
- Customer Service
- Interpersonal and Management Skills
Languages
English
Professional
Tagalog
Native/ Bilingual
References
References available upon request.
Timeline
Provider Relations Rep III
Alameda Alliance for Health
04.2024 - Current
Member Services Rep I - Bilingual
Alameda Alliance for Health
08.2021 - 04.2024
Operations Assistant/Sales Rep
Verizon Cellular Sales
01.2020 - 08.2021
Sales Consultant
AT&T
08.2018 - 10.2019
Integrated Sales and Support
Foxit Software
03.2017 - 07.2017
Technical Team Leader
Infinit-O Manila, Inc.
10.2015 - 12.2015
Team Leader
Concentrix
06.2014 - 10.2015
Graduate Certificate - ARTIFICIAL INTELLIGENCE AND BUSINESS ANALYTICS
DEVRY UNIVERSITY
MASTERS - BUSINESS ADMINISTRATION WITH CONCENTRATION IN INFORMATION SYSTEMS
DEVRY UNIVERSITY - KELLER GRADUATE SCHOOL OF MANAGEMENT
BACHELOR OF SCIENCE - COMPUTER SCIENCE
ASIAN COLLEGE OF SCIENCE & TECHNOLOGY
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