Overview
Work History
Education
Languages
Timeline
Generic

Crystal Giselle Rivera

Las Vegas

Overview

8
8
years of professional experience

Work History

Advocate4Me Representative - M&R Division

United Healthcare
08.2022 - Current
  • Receiving calls coming in high volume to identify member concerns; as well as asking inquisitive questions to identify member's spoken and non-spoken needs.
  • Coordinate with provider's as well as internal departments in order to ensure member's concerns are properly resolved.
  • Communicate and collaborate with fellow team member's and management as needed to address member inquiries as well as to improve interpersonal communication.
  • Navigate and leverage multiple computer systems to ensure first call resolution.
  • In depth analysis of member's accounts to ensure proper benefit information are being provided.
  • File appeals and grievances as well as determining when it's appropriate to initiate a prior authorization for both medical or prescription services.

Administrative Specialist

POP Prosthetics
04.2019 - 04.2022
  • Utilized strong organizational skills to manage multiple tasks simultaneously in a fast-paced environment.
  • Completed accurate data entry for all patient paperwork.
  • Reviewed CPT/ICD-10 codes and clinical notes to ensure compliance with insurance guidelines.
  • Utilized the Opie billing system at check-out to properly collect patient copay’s or coinsurance's as needed.
  • Assisted with training new hire's to educate employees on the various systems that were required to complete job functions.
  • Acted as a subject matter expert for fellow peers and new hires.

Warehouse Associate

Loyalty Brand Marketing
12.2018 - 03.2019
  • Prepared orders for shipment by picking, packing, and labeling merchandise.
  • Collaborated with team members to achieve daily targets and complete tasks efficiently.
  • Displayed adaptability by taking on various roles within the warehouse as needed, including receiving, shipping, or inventory control duties.
  • Consistently met or exceeded productivity targets while maintaining high standards for quality and safety.

Sales Advisor

OfficeMax
04.2018 - 11.2018
  • Developed customer service skills to provide a high level of satisfaction for customers.
  • Listened to customer details and offered matching solutions to meet wide range of requirements.
  • Maintained current knowledge of applicable sales and product changes in order to provide best possible service for all customer needs.
  • Resolved customer complaints promptly with empathy and understanding.
  • Educated customers on features, advantages, and benefits of various products or services offered.

Cashier

Walmart
02.2017 - 11.2017
  • Greetedd customers entering the store and responded promptly to customer needs.
  • Worked closely with shift manager to solve problems and handle customer concerns.
  • Operated cash register for cash, check, and credit card transactions with excellent accuracy levels.
  • Worked flexible schedule and extra shifts to meet business needs

Education

High School Diploma -

Valley High School
Las Vegas, NV
06-2016

Languages

English
Native or Bilingual
Spanish
Native or Bilingual

Timeline

Advocate4Me Representative - M&R Division

United Healthcare
08.2022 - Current

Administrative Specialist

POP Prosthetics
04.2019 - 04.2022

Warehouse Associate

Loyalty Brand Marketing
12.2018 - 03.2019

Sales Advisor

OfficeMax
04.2018 - 11.2018

Cashier

Walmart
02.2017 - 11.2017

High School Diploma -

Valley High School

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Crystal Giselle Rivera