Amber Guerrero Esparza
Tucson
Summary
Professional with strong background in medical claims analysis, adept at ensuring accurate and timely processing of healthcare claims. Skilled in data management, compliance, and problem-solving, with keen eye for detail. Focused on team collaboration and achieving results, adaptable to changing needs, and reliable in high-pressure environments. Strong analytical skills and thorough understanding of healthcare regulations and insurance policies. Self-motivated, hard-working, energetic team player Exceptional ability to work with culturally diverse populations Ability to multi task and work independently Strong clerical skills Proficient with the Microsoft Office, Outlook, Excel, Amisys, Cenpas, TruCare, FileNet, as well as Impeccable organizational skills
Overview
19
19
years of professional experience
Work History
Medical Claims Analyst
Cenetene
06.2022 - Current
- Reviewed and processed medical claims to ensure accuracy and compliance with established guidelines.
- Utilized data analysis skills to identify trends in claims submissions and improve processing efficiency.
- Maintained up-to-date knowledge of regulatory changes affecting medical claims processing.
- Documented and tracked claim adjustments and denials for future reference and analysis.
- Managed high-volume caseloads for optimal productivity while maintaining strict attention to detail.
Senior Customer Service Advocate
OptumRx
09.2016 - 06.2022
- Provide exceptional customer service
- Answer multi-line telephone and direct calls as necessary
- Pull data from multiple sources to create reports using Microsoft Excel
- Maintain Outlook calendar and schedule meetings and appointments
- Timely resolution of customer issues and complaints
- Service recovery – ensure client satisfaction on every interaction
- Daily correspondence with team members and leadership, using Word, Outlook and Excel
- Resolved customer inquiries and complaints through effective communication and problem-solving skills.
- Maintained accurate and detailed records of customer interactions for future reference and quality assurance.
Receptionist / Office Manager
AAAXE Trees and Landscape
12.2014 - 09.2016
- Timely, accurate completion of in-depth projects
- Provided and analyzed data using Excel spreadsheets
- Answered telephone and scheduled appointments
- Checked and responded to emails daily
- Scheduled and attended staff meetings
- Research of available and upcoming contracts
- Sent timely job estimates and invoices to clients
- Accurate recordkeeping
Front Desk / Customer Service
Arizona Mountain Inn and Cabins
01.2007 - 12.2007
- Answered multi-line telephone and directed calls
- Greeted, registered, and assigned rooms to guests of hotel
- Ensured guests’ needs were met and their stays were above expectation
- Verified customers’ credit, and ensured timely payment for accommodations
- Scheduled housekeeping or maintenance staff when guests report problems, ensured timely resolution
- Made and confirmed reservations
Education
High School Diploma -
Flagstaff High School
Flagstaff, AZ05-2004
Skills
- Claims processing proficiency
- HIPAA compliance
- Training and mentoring
- Medical terminology
ADDITIONAL EXPERIENCE
- Tucson Racquet and Fitness Club Server Tucson, Arizona December 2014 – September 2016
- Shooters Restaurant Server Tucson, Arizona October 2012 – December 2014
- Cruisers Route 66 Café Server Tucson, Arizona August 2011 – February 2012
Timeline
Medical Claims Analyst
Cenetene
06.2022 - Current
Senior Customer Service Advocate
OptumRx
09.2016 - 06.2022
Receptionist / Office Manager
AAAXE Trees and Landscape
12.2014 - 09.2016
Front Desk / Customer Service
Arizona Mountain Inn and Cabins
01.2007 - 12.2007
High School Diploma -
Flagstaff High School