Analaura Lombera Aguirre
Fresno,CA
Overview
12
12
years of professional experience
Work History
Bilingual Call Center Agent, CICC
Foundation for California Community Colleges
Fresno, CA
06.2024 - 11.2024
- Handled inquiries related to benefits and eligibility in a professional, resourceful, and empathetic manner.
- Determine eligibility by comparing client information against established requirements.
- Performed research using available resources, and routed calls appropriately.
- I multitasked and remained calm under pressure, especially during peak hours or difficult calls; I de-escalated situations as needed.
- Completed call notes and call reports as necessary, and updated them in the CRM.
CSR
Qualfon/Delta Dental
Fresno, CA
04.2023 - 10.2023
- Customer service helps medical and dental members with warm transfers, appointments, and documenting calls.
- (Conlan, authorization approvals and history info)
- Answering provider calls with member inquiries (claims, TAR, NOA).
- Processing documents in MMIS, MACESS, CRM, and EDI.
Fact Finding Agent - Claim Processing
Aston Carter
Fresno, CA
08.2021 - 12.2022
- Answered a constant flow of customer calls with minimal wait times.
- Analyzing claim information to identify discrepancies or missing information.
- Assessing the information against requirements based on UI code, policies, and procedures.
- Sending employers standard forms to obtain additional information, or to clear up a discrepancy.
- Working closely with subject matter experts to further understand how to address outstanding issues, or identify when a claim needs to be escalated.
- Reviewing and resolving complex issues referred by other frontline staff.
- Reviewing wage and income information, benefits payments, and cross-matching to determine if payments were made appropriately.
- Notating all actions taken on a claim clearly and thoroughly.
- Demonstrating the ability to make logical decisions.
- Demonstrating the ability to manage a workload in a way that meets timeliness requirements.
- All other duties, as assigned by management, to support claim processing.
CSR - Customer Service Representative
Highlands Energy
Fresno, CA
04.2018 - 01.2019
- CSR for a third party contracted by PG&E.
- Helping customers get pre-approved for low-income programs
Customer Service Representative
Alorica Calling Center
Fresno, CA
04.2013 - 10.2014
- Working in a fast-paced environment.
- Helped customers with questions regarding their accounts, and processed payments.
- As well as assisting them with troubleshooting, or any other technical support the customers requested.
Education
Child Development -
Fresno City College
Fresno, CASkills
- Customer service
- Communication skills
- Computer literacy
- Bilingual (Spanish)
- Microsoft Word
- Analysis skills
- Mac OS
- Data entry
- Paperwork processing
- CRM
Timeline
Bilingual Call Center Agent, CICC
Foundation for California Community Colleges
06.2024 - 11.2024
CSR
Qualfon/Delta Dental
04.2023 - 10.2023
Fact Finding Agent - Claim Processing
Aston Carter
08.2021 - 12.2022
CSR - Customer Service Representative
Highlands Energy
04.2018 - 01.2019
Customer Service Representative
Alorica Calling Center
04.2013 - 10.2014
Child Development -
Fresno City College