Compassionate Healthcare Professional with over 18 years of diverse experience in patient care and customer service. Proficient in health records management, call handling, and compliance standards, while maintaining HIPAA protocols to safeguard patient privacy. Demonstrated ability to enhance patient satisfaction through effective communication and empathetic support. Proven track record of optimizing processes and fostering teamwork to meet healthcare objectives. Ready to leverage unique skills to elevate patient experiences in a remote call center environment.
Overview
33
33
years of professional experience
Work History
Home Heath Medical Aide
Unknown
02.2007 - 05.2025
Maintained cleanliness of the work area in accordance with safety protocols.
Collaborated with healthcare teams to assess needs and fulfill daily objectives.
Greeted patients and provided assistance with required paperwork.
Supported employees in scheduling computer and phone updates.
Assisted administrative departments with paperwork, errands, and various clerical duties.
Collected specimens for testing and prepared them for laboratory analysis.
Escorted patients before and after surgical procedures.
Maintained detailed patient records, including medical histories, reports, and examination results.
Provided basic patient care, including changing dressings, bathing, feeding, and assisting with ambulation.
Monitored vital signs such as pulse rate, temperature, blood pressure, and weight of patients.
Ensured compliance with HIPAA protocols to protect patient privacy.
Educated patients about their health conditions and prescribed medications.
Ensured proper sterilization of all equipment before use on different patients.
Restocked supplies and cleaned equipment between patient visits.
Transported patients to various departments for further evaluation or treatment.
Executed basic, non-invasive medical assistant duties.
Cultivated strong and trusting relationships with clients and their families.
Executed day-to-day responsibilities accurately and effectively.
Optimized time management to ensure timely completion of tasks and deadlines.
Customer Service Representative
Aetna
08.2001 - 11.2006
Utilized advanced technical skills to troubleshoot complex problems and devise solutions.
Enhanced customer satisfaction by delivering knowledgeable and friendly service to resolve issues.
Maintained current knowledge through ongoing professional development and advanced training.
Collaborated successfully with a diverse group of coworkers to achieve goals and address product and service-related issues.
Managed time effectively to ensure tasks were completed on schedule and deadlines were met.
Leveraged various software and tools to streamline processes and enhance performance.
Underwriting Support Specialist
GRL Medicare
08.1999 - 03.2003
Verified the accuracy of information provided by potential borrowers through extensive research.
Developed rates for new and renewal groups in compliance with underwriting guidelines.
Partnered with colleagues to review and process new and renewal business applications.
Prepared documentation packages for Underwriter review, ensuring accuracy and thoroughness.
Documented all customer interactions promptly in the company database system.
Collaborated closely with underwriting team members to ensure timely completion of tasks.
Responded promptly to customer inquiries via email and telephone calls.
Evaluated financial statements, credit information, and title data to complete the underwriting process.
Ensured all underwriting activities adhered to company policies and external regulations.
Executed day-to-day responsibilities accurately and efficiently.
Gathered additional applicant documentation as needed to facilitate underwriting decisions.
Communicated with field representatives and medical personnel to obtain further information or clarify underwriting policies.
Maintained up-to-date knowledge of underwriting policies, procedures, and regulations.
Claims Examiner
Highmark Blue Cross Blue Shield
04.1992 - 06.1999
Executed cost-benefit analyses on claim handling procedures to identify efficiency improvements.
Reduced loss ratios through fair and prompt claims processing.
Maintained comprehensive understanding of fraudulent and illegal practices within the industry.
Provided guidance to coworkers regarding claim processing rules and regulations.
Negotiated settlement terms with claimants within authorized limits.
Evaluated the acceptability of claims from third parties and gathered comprehensive information.
Reviewed and assessed insurance claims to determine coverage and validity.
Analyzed information gathered from investigations and reported findings and recommendations.
Coordinated with legal counsel on complex claims requiring litigation.
Tracked the progress of pending cases through manual follow-up or automated systems.
Participated in quality assurance activities, such as peer reviews and audits.
Collaborated with underwriters to recommend policy changes based on claim trends.
Education
Certifications - Electronic Medical Records and Billing and Coding Specialist
University of Phoenix
New Cumberland, United States
01-2026
Skills
Data analysis
Computer skills
Health records management
Troubleshooting
Administrative support
Customer service
Conflict management
Time management
Communication skills
Timeline
Home Heath Medical Aide
Unknown
02.2007 - 05.2025
Customer Service Representative
Aetna
08.2001 - 11.2006
Underwriting Support Specialist
GRL Medicare
08.1999 - 03.2003
Claims Examiner
Highmark Blue Cross Blue Shield
04.1992 - 06.1999
Certifications - Electronic Medical Records and Billing and Coding Specialist
Home Heath aide/ special needs children and Household maintenance at George and Amanda OrtizHome Heath aide/ special needs children and Household maintenance at George and Amanda Ortiz