Anais Acosta
Summary
Innovative and customer-focused professional with a proven track record in service advocacy. Demonstrates exceptional problem-solving skills, conflict resolution abilities, and strong leadership traits. Skilled in building excellent rapport with customers, ensuring their complete satisfaction with services and products. Proficient in effectively resolving internal and external issues to drive productivity and maintain positive relationships.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Provider Service Advocate Sr
UnitedHealth Group, UHG
01.2023 - Current
- Answer incoming phone calls/chats from health care providers, physician offices, clinics) and identify the type of assistance the provider needs (ie. Benefit and eligibility, billing and payments, authorizations for treatment, explanation of benefits)
- Focus on resolving issues on the first call, navigating through complex computer systems to identify the status of the issue and provide appropriate response to caller
- Deliver information and answer questions in a positive manner to facilitate strong relationships with providers and their staff
- Complete the documentation necessary to track provider issues and facilitate the reporting of overall trends.
- Supported team members, fostering a collaborative and productive work environment.
- Improved customer satisfaction by promptly addressing inquiries and resolving issues.
- Demonstrated empathy and active listening skills when dealing with frustrated customers, diffusing tense situations effectively.
- Enhanced client retention through exceptional service delivery and proactive communication.
- Handled escalations professionally, demonstrating composure under pressure while finding satisfactory solutions for both parties involved.
- Exceeded performance metrics consistently by prioritizing tasks effectively and efficiently.
- Documented calls accurately, maintaining organized records for future reference or escalation purposes if needed.
- Managed high call volumes while maintaining quality service standards and positive customer interactions.
Licensed REALTOR & Commercial Sales Agent// Property Manager
Homes by Anais
12.2017 - Current
- GA & TX Licensed REALTOR and Property Manager Commercial & Residential
- Conducted comprehensive market analyses to determine optimal listing prices for sellers, maximizing profits while minimizing time on market.
- Maintained up-to-date knowledge of local market trends and regulations, providing valuable insights and advice to clients.
- Coordinated appointments with buyers, sellers and other realtors to show buyers and tenants prospective homes.
- Facilitated smooth transactions by coordinating with various stakeholders such as title companies, inspectors, appraisers, and attorneys.
- Negotiated favorable terms for clients during contract discussions, ensuring their best interests were represented.
- Collaborated with mortgage lenders to secure financing options for clients, expediting the closing process.
- Provided expert guidance on property improvements to enhance value prior to sale or rental listings.
- Implemented efficient systems for managing paperwork and tracking client communication history, improving overall organization and productivity levels.
- Expanded client base through targeted networking efforts and referral programs, resulting in increased business opportunities.
Community & State Member Benefits/Eligibility Representative
Aetna, a CVS Health Company
10.2022 - 06.2023
- Answers questions and resolves issues as a "single-point-of-contact" based on phone calls, plan sponsors, PSS/ISO, members and providers
- Provides customized interaction based on customer preference and individualized needs, creating an emotional connection with our members by understanding and engaging the member to the fullest
- Provides the customer with related information to answer the unasked questions, e.g
- Additional plan details, benefit plan details, member self-service tools, etc
- Educates and assists customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company (i.e., assistance with member self-service tools, Consultation Opportunities - Simple Steps, Cost of Care Tools, Natural Alternatives Program, etc.)
- Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility, processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals
- Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction
- Utilized data-driven decision-making strategies to make informed recommendations on complex cases.
- Contributed positively to team culture by actively participating in collaborative problem-solving efforts.
- Assisted clients with navigating complex eligibility requirements, ensuring accurate submissions.
- Streamlined workflow for faster application processing, resulting in improved turnaround times.
- Exceeded performance metrics consistently by accurately determining program eligibility within established timeframes.
Customer Retention Specialist
American Income Life
07.2021 - 03.2022
- Responsible for conserving business on behalf of the Company as a vital part of a dedicated, professional team
- We ensure that customers who call in with the intention of canceling are provided assistance in understanding the importance of keeping their coverage, as well as providing policy maintenance.
- Implemented targeted outreach campaigns to re-engage inactive customers and boost repeat business.
- Reduced churn rate by developing personalized retention strategies for high-risk clients.
- Adhered to appropriate legal scripting when required.
- Championed a company-wide initiative focused on creating a culture of exceptional customer service delivery across all departments.
- Conducted regular account reviews to identify opportunities for improving customer satisfaction and reducing attrition rates.
- Established strong relationships with key accounts, fostering loyalty and long-term client retention.
- Played a pivotal role in achieving record-breaking customer retention rates year-over-year within the organization.
- Introduced automated tools that streamlined the process of identifying at-risk clients, enabling more effective intervention efforts.
Vaccination Administrative Lead
Favorite Healthcare Staffing
03.2021 - 07.2021
- As an administrator for the vaccine program, I was responsible for providing administrative support on all vaccination activity inside the pod working closely with the vaccinator to support the effective delivery of the vaccine, providing excellent customer service to all citizens
- Welcomes patient/family and establishes rapport
- Explains what vaccines will be given and which type(s) of injection(s) will be done
- Answers questions and accommodates language or literacy barriers and special needs of patient/parents to help make them feel comfortable and informed about the procedure
- Verifies patient/parents received Vaccine Information Statements (VISs) for indicated vaccines and has had time to read them and ask questions
- Screens for contraindications (if within employee's scope of work)
- Reviews comfort measures and aftercare instructions with patient/parents, and invites questions
- Identifies the location of the medical protocols (e.g., immunization protocol, emergency protocol, reporting adverse events to the Vaccine Adverse Event Reporting system [VAERS], reference material)
- Identifies the location of epinephrine, its administration technique, and clinical situations where its use would be indicated
- Maintains up-to-date CPR certification
- Understands the need to report any needlestick injury and to maintain a sharps injury log
- Demonstrates knowledge of proper vaccine handling (e.g., maintains and monitors vaccine at recommended temperature and protects from light).
- Improved office efficiency by streamlining administrative processes and implementing time-saving strategies.
- Enhanced team productivity through effective delegation of tasks and close monitoring of progress.
- Implemented training programs for new hires to ensure a smooth onboarding experience.
- Reduced errors in documentation by implementing meticulous proofreading and quality control measures.
- Maintained a high level of confidentiality when handling sensitive information, adhering to company policies regarding privacy protection.
- Coordinated team schedules to ensure adequate coverage during peak times and vacation periods.
- Resolved conflicts within the team diplomatically, promoting open communication among all members to foster collaboration.
- Established workflow processes, monitored daily productivity, and implemented modifications to improve overall performance of personnel.
Customer Service Representative/Technical Support
Asurion
11.2019 - 09.2020
- Provided customer service & technical support assistance for ATT Wireless Protech & Internet
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Contributed to sales growth by upselling products and services based on individual customer requirements.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
Operations Manager
Concierge Auto Rental
04.2014 - 06.2016
- Operations Manager/HR/Accounting (Payables/Receivables)
- Prepare financial reports by collecting, analyzing, and summarizing account information and trends
- Maintain accounting ledgers by posting account transactions and processing monthly bank reconciliations
- Pay invoices by verifying transaction information; Settle accounts and analyzed accounts receivable reports
- Following internal accounting controls to maintain financial security; streamlined all team billing and registration functions to facilitate accountability, reliability, and accuracy of information
- Prepared, filled, and paid sales tax returns and payroll tax returns
- Research discrepancies of financial information and/or documentation for the purpose of ensuring the accuracy and adhering to established procedures prior to processing
- Respond to inquiries of staff and administration regarding financial procedures for the purpose of providing information, direction and/or referral for addressing inquiry
- Prepare the weekly payroll.
- Supervised operations staff and kept employees compliant with company policies and procedures.
- Empowered employees to take ownership of their responsibilities, leading to increased accountability and improved performance outcomes.
- Conducted regular performance reviews, identifying areas for improvement and developing action plans to address them.
- Managed inventory and supply chain operations to achieve timely and accurate delivery of goods and services.
- Established positive and effective communication among unit staff and organization leadership, reducing miscommunications, and missed deadlines.
- Achieved higher employee retention rates by fostering a positive work environment and providing opportunities for professional growth.
- Developed and implemented strategies to maximize customer satisfaction.
Education
Bachelor of Science - Business Administration And Management
Capella University
Minneapolis, MN12.2024
Licensed - Real Estate Development in Residential & Commercial
American School of Real Estate Express
Houston, TX12.2017
Associate of Arts - Business Office Technology
Augusta Technical College
Augusta, GA05.2004
High School Diploma -
New Jersey Youth Academy
Fort Dix, NJ08.2002
Skills
- Internal Audit
- Quickbooks Pro
- Desktop Publishing
- Account Analysis
- Bank Reconciliation
- Journal Entries
- General Ledger Accounting
- Office Management
- Account Reconciliation
- Accounts Payable
- Google Suite
- Auditing
- Financial Statement Preparation
- Accounts Receivable
- Tax Experience
- Interviewing
- Decision-making skills
- Customer service background
- Complaint Handling
- Complex Problem-Solving
Certification
Real Estate License
General Lines Insurance License
Additional Information
SKILLSTyping (55+wpm), Proficient in QuickBooks Pro; Microsoft Office including but not limited to Access, Excel, and Power Point; Proficient in Data Management & Desktop Publishing; Experience with DTS; Experience with TSD (Rental Software); Internal Audit Control experience; Licensed REALTOR; HAR/TAR Member; Licensed Insurance Broker
Assessments
- Attention to detail, Proficient, 09/01/22
- Typing, Proficient, 09/01/22
- Scheduling, Proficient, 09/01/22
Workauthorization
Authorized to work in the US for any employer
Personal Information
Willing To Relocate: Anywhere
Affiliations
- Delta Mu Delta Honor Society
Timeline
Provider Service Advocate Sr
UnitedHealth Group, UHG
01.2023 - Current
Community & State Member Benefits/Eligibility Representative
Aetna, a CVS Health Company
10.2022 - 06.2023
Customer Retention Specialist
American Income Life
07.2021 - 03.2022
Vaccination Administrative Lead
Favorite Healthcare Staffing
03.2021 - 07.2021
Customer Service Representative/Technical Support
Asurion
11.2019 - 09.2020
Licensed REALTOR & Commercial Sales Agent// Property Manager
Homes by Anais
12.2017 - Current
Operations Manager
Concierge Auto Rental
04.2014 - 06.2016
Bachelor of Science - Business Administration And Management
Capella University
Licensed - Real Estate Development in Residential & Commercial
American School of Real Estate Express
Associate of Arts - Business Office Technology
Augusta Technical College
High School Diploma -
New Jersey Youth Academy