Andres Benavides
Clearwater,FL
Summary
Highly motivated, responsible and reliable individual with over 10 years of experience working in the customer service industry. Demonstrated ability to multi-task and prioritize in a fast-paced environment while meeting goals set by management. Ability to navigate multiple software programs quickly to identify solutions to customer problems, Proficient at de-escalating situations while maintaining a professional demeanor. Motivated professional offering proficiency in data entry able to efficiently maintain customer database by entering new and updated information, transcribing physical documents as well as verifying data by comparing it to source documents.
Overview
13
13
years of professional experience
Work History
Case Manager
Medicaid Done Right
01.2022 - 12.2022
- Managed over 15 cases on a daily basis, checking for updates and requirements from case workers as well as updating received documents to DCF
- Maintains communication with case workers, nursing homes and family member of patients applying for Medicaid
- Required to submit Medicaid applications to DCF and to follow up with any documentation requested by case workers
- Evaluates applicant's income and assets to identify potential issues with Medicaid Application
- Able to provide applicants and family members with legal tools to resolve issues when applicant is over income and / or asset limit for the state of Florida
- Knowledgeable about Florida's Medicaid Eligibility guidelines
- Responsible for thoroughly reviewing documents such as bank statements to determine potential things the case worker might ask for.
Administrative Processor
ADT Health
01.2020 - 01.2022
- Able to process and return incoming documents such as Authorizations and EOBs
- Outbound and inbound calls to Case managers, agencies, and customers regarding medical alarms
- Proactively takes ownership of potential issues and interacts successfully with other departments and management
- Ensures customer satisfaction by resolving issues on the first call whenever possible
- Multi-tasks while keeping the customer engaged
- Follows-up with the customer until the issue is resolved
- Diffuses escalated conversations
- Reads and comprehends documents
- Updates account information including billing and personal information.
Customer Care Representative
American Insurance Administrators
01.2018 - 01.2020
- Responsible for assisting both providers and policy holders alike with eligibility and benefits
- Follows all Medicare, HIPAA, and Private Insurance regulations and requirements
- Able to provide claim status and reasons for denial to policy holders and providers
- Required to provide policy holders with assistance and support when needed
- Maintains friendly yet professional tone while assisting providers and policy holders
- Able to assist agents with applications
- Responsible for assisting policy holders, prospects policyholders, providers, and agents with valuable information regarding Policy information and status, application status and also claims while following HIPAA guidelines and remaining professional yet friendly with callers.
Patient Support Representative
CCS Medical
01.2016 - 01.2018
- Outbound and inbound call to patients regarding medical supplies
- Required to be able to fax, scan and email medical documents when needed
- Builds and maintains strong, professional relationships across business units
- Provides support to patients as needed to maximize current and future orders
- Maintains a high level of communication with the assigned department supervisor
- Evaluates insurance coverage in order to determine compatibility with our program
- Always maintains a high degree of confidentiality due to access to sensitive information
- Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
- Follows all Medicare, Medicaid, HIPAA, and Private Insurance regulations and requirements
- Abides by all regulations, policies, procedures and standards of the company
- Maintains positive internal and external customer service relationships.
Concierge Specialist
Freedom Health
01.2015 - 01.2016
- Responsible for assisting members of HMO plans from Freedom Health and Optimum Health
- Basic Microsoft excel and outlook skills essential to position
- Required to aid members with any difficulties they might encounter while providing outstanding customer service and following HIPAA law guidelines.
Survey Research
Conifer Patient Communications
01.2012 - 01.2015
- Outbound customer service calls for Hospitals' patients regarding their experiences while in the hospital
- Required to keep a production of 80% or higher and a 90 % or higher quality
- Basic Microsoft excel and outlook skills essential to position
- Able to successfully interact with patients without breaking any HIPAA law.
Houseman
Hilton
01.2012 - 01.2012
- Assist guests with any request to ensure a positive guest experience
- Assist with cleaning rooms for 'early check-ins'
- Assisted with translation for Hispanic guests and employees.
Research Interviewer
Nielsen Media Research
01.2010 - 01.2012
- Outbound customer service calls for T.V
- Ratings, Mobile Phones (Bilingual)
- Responsible for collecting accurate data
- General office administrator abilities, utilizing Microsoft Office software such as Outlook, Word, Excel.
Education
Some College (No Degree) - Health Services Administration
Keiser University
Tampa High School Diploma -
Clearwater High School
Clearwater, FL01.2010
Skills
- Patient Support
- Records Management
- Client Advocacy
- Care Coordination
- Quality Assurance Controls
- Data Entry and Analysis
- Documentation and Reporting
- Medical Records Management
- First Call Resolution
- Research and Data Collection
- Adaptability and Flexibility
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Case Manager
Medicaid Done Right
01.2022 - 12.2022
Administrative Processor
ADT Health
01.2020 - 01.2022
Customer Care Representative
American Insurance Administrators
01.2018 - 01.2020
Patient Support Representative
CCS Medical
01.2016 - 01.2018
Concierge Specialist
Freedom Health
01.2015 - 01.2016
Survey Research
Conifer Patient Communications
01.2012 - 01.2015
Houseman
Hilton
01.2012 - 01.2012
Research Interviewer
Nielsen Media Research
01.2010 - 01.2012
Some College (No Degree) - Health Services Administration
Keiser University
High School Diploma -
Clearwater High School
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