Summary
Overview
Work History
Education
Skills
Certification
Timeline
Generic

ALYSSA ALVAREZ

San Antonio

Summary

Results-oriented professional with a demonstrated history of success in recovering delinquent payments. Proven expertise in creating and executing collection strategies that reduce delinquency rates and maximize efficiency. Skilled in negotiating and resolving accounts in collections. Detail-oriented medical professional experienced in providing medical administrative and clinical support in a busy medical office. Proficient in EMR and other medical software, with strong knowledge of medical terminology and HIPAA regulations. Dedicated to providing an efficient and accurate healthcare experience. Hardworking professional with experience in sales and customer service. Excellent communicator with strong interpersonal and problem-solving skills. Proven ability to build relationships with customers, identify needs and provide comprehensive insurance coverage. Highly organized and detail-oriented worker, with a drive to exceed expectations. Ability to analyze data, develop strategies, and provide solutions to complex problems. Seeking to leverage skills and knowledge to contribute to team success.

Experienced with fraud detection, risk assessment, and mitigation strategies. Utilizes advanced analytical techniques to identify potential threats and implement preventive measures. Track record of maintaining high standards in fraud prevention, ensuring integrity and security of organizational operations.

Overview

6
6
years of professional experience
1
1
Certification

Work History

Fraud Prevention Specialist

Conduent Call Center
08.2024 - 07.2025
  • Analyzed transaction data to identify and mitigate fraudulent activities.
  • Developed and implemented fraud detection strategies to enhance security measures.
  • Collaborated with cross-functional teams to streamline fraud prevention processes.
  • Trained staff on best practices for identifying potential fraud risks.
  • Conducted investigations into suspicious transactions, ensuring compliance with regulations.
  • Monitored real-time alerts and escalated high-risk cases for further review.
  • Prepared detailed reports on fraud incidents and prevention efforts for management review.
  • Utilized advanced analytics tools to improve accuracy of fraud detection systems.
  • Maintained detailed records of all investigations conducted, providing valuable data for trend analysis and future case management efforts.
  • Managed complex cases involving identity theft, credit card fraud, and other forms of financial crime, resulting in successful resolution for affected customers.
  • Supported colleagues in navigating difficult situations involving potential fraud by providing timely advice based on professional expertise and experience.
  • Conducted thorough investigations of suspected fraud cases, leading to the recovery of lost funds.
  • Developed comprehensive fraud prevention strategies to protect company assets and maintain customer trust.
  • Worked closely with IT departments to ensure security systems were optimized for detecting and preventing fraud attempts, safeguarding company assets.
  • Collaborated with cross-functional teams to update and enforce security protocols, minimizing vulnerabilities.

Customer Service Representative

Ansafone Communications
06.2023 - 12.2023
  • Coordinated with healthcare providers to schedule appointments and manage patient records efficiently.
  • Resolved patient inquiries and concerns, ensuring timely and accurate information delivery.
  • Collaborated with cross-functional teams to enhance overall patient experience and satisfaction levels.
  • Managed electronic health records system to maintain data accuracy and compliance standards.
  • Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
  • Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
  • Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
  • Followed up with customers about resolved issues to maintain high standards of customer service.
  • Responded to customer requests, offering excellent support and tailored recommendations to address needs.
  • Maintained organized records of prescriptions, ensuring confidentiality and regulatory compliance.
  • Assisted pharmacy staff with preparing medications and filling orders.

COLLECTIONS AGENT

CMIGroup
09.2022 - 04.2023
  • Monitored outstanding account balances and determined need for further collections action.
  • Negotiated with customers to reach payment agreements.
  • Generated invoices and sent out payment reminders.
  • Prepared detailed reports of discrepancies, presenting to management for approval prior to collecting.
  • Analyzed credit reports to assess customer payment history.
  • Monitored accounts and credit reports to identify delinquent and high-risk customers.
  • Maintained a thorough understanding of legal regulations related to collections.
  • Worked closely with management to resolve or assist in customer delinquency issues.
  • Recorded and maintained records of billing addresses, credit limits and billing frequency.
  • Leveraged payment plan system to reduce customer delinquency.
  • Processed customer refunds and account adjustments, updating records in database.
  • Performed various administrative functions for assigned accounts, such as recording address changes and purging records of deceased customers.
  • Checked on status of claims payments and wrote appeal letters for denial on claims.

CUSTOMER SVCS REP.

CVS-AETNA
04.2021 - 06.2022
  • Contacted prospective and current clients via telephone to provide quote and policy information.
  • Analyzed insurance policies to verify compliance with state and federal regulations.
  • Analyzed clients' current insurance policies and suggested additions or other changes.
  • Interpreted insurance policies and explained coverage to clients.
  • Explained necessary bookkeeping requirements for customer to implement and provide group insurance program.
  • Communicated with providers to obtain and verify eligibility information.
  • Assisted with prior- authorization and or denial for services scheduled for customers.
  • Addressed customers courteously using suitable methods and problem-solving skills.
  • Explained partial and full denials for items not covered under policies.
  • Collaborated with other departments, customers and insurance companies to resolve claims in an efficient and timely manner.
  • Processed and resolved a wide range of property and casualty insurance claims, ensuring compliance with state and industry regulations.
  • Monitored and reported on claim status and performance metrics to management.

MEDICAL ASSISTANT

Oncology of San Antonio
12.2019 - 03.2021
  • Documented medical data in patient charts, facilitating accurate records.
  • Triaged patients and performed vital checks for patient flow facilitation.
  • Supported physicians in examinations, procedures, and diagnostic tests.
  • Scheduled appointments and maintained patient records.
  • Cleaned treatment rooms and medical instruments, complying with infection control standards.
  • Complied with personal protective equipment requirements to protect against exposure to infectious body fluids and other hazardous substances.
  • Monitored supply inventory for low stock and worked with staff to reorder.
  • Provided patient education and post-visit care instructions to foster care continuum.
  • Assisted physicians and nursing personnel with injections, phlebotomy, and other patient care procedures.
  • Stocked supplies and instruments for examination rooms.
  • Delivered administrative support to medical practices, aiding in quality healthcare services.
  • Obtained patient medical histories for inclusion in records.
  • Conducted pre-authorizations and referrals to meet third-party insurer requirements.
  • Prioritized patient needs identified through phone, electronic, and walk-in communication to comply with established guidelines.
  • Performed patient intake and assisted in patient care procedures.
  • Worked interdependently with other professionals to provide quality health care to patients.
  • Helped prepare medical instruments and equipment.
  • Performed routine laboratory tests and sample analyses.
  • Changed dressings on wounds.
  • Collected blood, tissue and other laboratory specimens, logged specimens, and prepared them for testing.
  • Explained treatment procedures, medications, diets, or physicians' instructions to patients.

Education

CCMA - Medical

Souther Careers Institute
San Antonio, Texas
04.2019

High School Diploma - undefined

S.A. Leadership Academy
San Antonio, Texas
06.2017

Skills

  • Leadership skills
  • Problem solving
  • Computer Proficiency
  • Data Analysis
  • Administration Skills
  • Communication Skills
  • Attention to detail
  • Organizational skills
  • Negotiation
  • Fraud prevention strategies
  • Critical thinking
  • Conflict resolution
  • Financial transactions monitoring
  • Investigation techniques
  • Verbal and written communication
  • Time management
  • Problem-solving
  • Teamwork and collaboration
  • Multitasking
  • Telephone and email etiquette
  • Active listening
  • Effective communication
  • Adaptability and flexibility
  • Decision-making
  • Detail-oriented
  • Professionalism
  • Data analysis
  • Dispute resolution
  • Proficient in [software]

Certification

CCMA-Certified Clinical Medical Assistant

Timeline

Fraud Prevention Specialist

Conduent Call Center
08.2024 - 07.2025

Customer Service Representative

Ansafone Communications
06.2023 - 12.2023

COLLECTIONS AGENT

CMIGroup
09.2022 - 04.2023

CUSTOMER SVCS REP.

CVS-AETNA
04.2021 - 06.2022

MEDICAL ASSISTANT

Oncology of San Antonio
12.2019 - 03.2021

High School Diploma - undefined

S.A. Leadership Academy

CCMA - Medical

Souther Careers Institute

Similar Profiles

CREATE PROFILE