ROSE RAMIREZ
Avondale,AZ
Summary
Qualified Claims Representative versed in investigating claims, verifying information and managing settlements. Friendly and upbeat team player with organized and disciplined approach. Offering 6 years of insurance experience. Background includes [vehicles and medical claims processing in fast-paced environments. Adept at handling uncomplicated claims from first contact through final settlement. Fluent in Spanish .
Overview
8
8
years of professional experience
Work History
CLAIMS ADVOCATE
CVS
Chandler, AZ
04.2020 - Current
- Answering incoming call for CVS members
- Going over claims answering any questions
- Regarding there health ins making sure
- They are understanding everything they need
- Know about deductibles, copays, coinsurance
- Followed up with customers on unresolved issues.
- Verified client information by analyzing existing evidence on file.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
CLAIM SPECIALIST
MAPFRE
GILBERT, Arizona
- 09.2015
- Answering incoming phone calls from insured
- To set up their claims and answer any questions
- Regarding their insurance policy
DATA XPORT
EL PASO, Texas
03.2015 - 08.2015
- Answering inbound calls regarding there discount that they have submitted
- Through the Verizon web site.
- Assisting the customer on steps to validate
- Employment
- Demonstrated respect, friendliness and willingness to help wherever needed
CUSTOMER SERVICE
XEROX COMMERCIAL SOLUTIONS LLC
03.2014 - 08.2015
- Perform duties too varied and diverse to be classified in any specific office clerical occupation, requiring limited
- Knowledge, incoming calls from customers regarding their cable, telephone, and internet troubleshooting there cable
- Boxes
- Adding additional services when needed
Customer Service Representative
Alorica Inc
El Paso, Texas
03.2012 - 11.2014
- Interact with customers to provide information in response to inquiries about products and services and to handle and
- Resolve complaints
- Check to ensure that appropriate changes were made to resolve customers' problems
- Compare disputed merchandise with original requisitions and information from invoices and prepare invoices for
- Returned goods
- Complete contract forms, prepare change of address records, or issue service discontinuance orders, using
- Computers
- Confer with customers by telephone or in person to provide information about products or services, take or enter
- Orders, cancel accounts, or obtain details of complaints
- Contact customers to respond to inquiries or to notify them of claim investigation results or any planned adjustments.
Customer Service Rep
Safelight Auto Glass
Chandler, Arizona
02.2011 - 02.2012
- Answering incoming calls and setting appointments for glass replacement, entering information for insurance
- Claims for the customer, entering credit card information for the sale, answering any questions customers have
- Regarding there windshield.
- Provided primary customer support to internal and external customers
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Cultivated customer loyalty, promoted repeat business and improved sales
Education
High School Diploma -
Thomas Jefferson High
El Paso, TX05.2008
Skills
- Insurance coverage verification
- Prior authorization processing
- Collaborative relationships
- Data integrity
- Patient contact
- Dependable and Responsible
- Data Entry
Languages
Spanish
Limited Working
Timeline
CLAIMS ADVOCATE
CVS
04.2020 - Current
DATA XPORT
03.2015 - 08.2015
CUSTOMER SERVICE
XEROX COMMERCIAL SOLUTIONS LLC
03.2014 - 08.2015
Customer Service Representative
Alorica Inc
03.2012 - 11.2014
Customer Service Rep
Safelight Auto Glass
02.2011 - 02.2012
CLAIM SPECIALIST
MAPFRE
- 09.2015
High School Diploma -
Thomas Jefferson High