Alayzia Pineda
The Woodlands,TX
Summary
I am a dedicated and self-driven Criminal Justice undergraduate student simultaneously working towards obtaining an EMT-B certification. I aim to prove myself as a worthy candidate for the position of Certified EMT/Firefighter Trainee in order to gain a deeper understanding of the role of a professional firefighter. Additionally, this position would provide me with the vital hands-on experience that will contribute to my success in the fire academy and my eventual career as a certified firefighter.
Overview
6
6
years of professional experience
Work History
Healthcare Customer Service Representative
UnitedHealthcare
11.2024 - Current
- Answered inbound calls using Genesys Cloud software, warmly greeted members, and verified HIPAA compliance to protect sensitive patient information at all times.
- Provided precise quotations for M&R/DSNP medical, wellness, and pharmacy benefits, including eligibility, deductibles, cost-sharing details, coverage specifics, OTC options, and balances.
- Successfully de-escalated upset members through compassionate and active listening, utilizing strong
problem-skills to identify and implement effective solutions. - Reviewed pharmacy claims, addressed pharmacy rejections, and facilitated Rx home deliveries.
- Maintained accurate records of customer interactions, ensuring proper documentation within the company's database.
Assistant Store Manager/Key Holder
Best Management Co. Inc
05.2020 - 03.2023
- Managed cash registers efficiently, ensuring accurate transactions, balancing drawers daily, and minimizing discrepancies.
- Managed opening and closing procedures, bank deposits, and reviews of inventory and sales to prepare reports for management.
- Consistently exceeded established sales goals through the implementation of custom sales techniques,
professional representation of company brand, and strong interpersonal skills. - Mentored new employees on company policies, expectations, and sale techniques to ensure their success within the company.
- Handled elevated customer inquiries regarding missing order items or cash-back discrepancies, delivering a
final resolution that adhered to company guidelines and procedures.
Sales Associate/Key Holder
Journeys
11.2018 - 11.2019
- Consistently achieved weekly personal sales goals through effective up-selling, thereby boosting store profit
margins. - Performed daily maintenance of shoe racks, clothing, and accessory shelves to uphold store aesthetics and
ensure a pristine sales floor. - Handled difficult and upset customers by addressing their concerns directly, and to their full satisfaction
through quick resolution, including processing returns and exchanges. - Ensured high levels of customer service satisfaction by utilizing my comprehensive knowledge of sizing, proper
care techniques, and expertise in locating out-of-stock products at alternate locations.
Education
Bachelor of Science - Criminal Justice
University of Houston - Downtown
Houston, TX01-2025
Emergency Medical Technician -
Northwest Community Health
Houston, TX01-2025
Associate of Arts -
Lone Star College
Houston, TX01-2022
High School Diploma -
Evolution Academy
Spring, TX01-2019
Skills
- HIPAA compliance
- Insurance verification
- Appointment scheduling
- Patient confidentiality
- Record Maintenance
- Critical decision-making skills
Languages
English
Native or Bilingual
Timeline
Healthcare Customer Service Representative
UnitedHealthcare
11.2024 - Current
Assistant Store Manager/Key Holder
Best Management Co. Inc
05.2020 - 03.2023
Sales Associate/Key Holder
Journeys
11.2018 - 11.2019
Bachelor of Science - Criminal Justice
University of Houston - Downtown
Emergency Medical Technician -
Northwest Community Health
Associate of Arts -
Lone Star College
High School Diploma -
Evolution Academy