Hi, I’m
Anthony Acosta
San Antonio,TX
Summary
Over 16 years of customer service developing and building positive relationships with members, customers, and clients. I look forward to joining a company that will present a career opportunity that will compliment my customer service experience.
Overview
11
years of professional experience
Work History
Optum CareSan Antonio, Texas
Supervisor
12.2022
Job overview
- 15 coordinators that were direct reports where I was responsible for meeting daily, weekly, and monthly goals including adherence, attendance, production, and quality standards
- Attended meetings daily, conducted 1on1s to develop coordinators and assist in their professional growth and development
- The coordinators worked both inbound and outbound building authorizations and handling claims as well.
Optum CareSan Antonio, Texas
Team Lead
08.2021 - 12.2022
Job overview
- Assist Prior Authorization reps with building cases, coaching’s, allotting time for offline work, and balancing workload for reps
- Attend meetings and offer ideas on process improvements
- Work daily with clinical (nurse leadership) staff to assist with workload and escalations that are time sensitive
- Answer questions in multiple teams chats so advocates have the tools necessary to help them deliver a positive member experience
- I am the SME and will provide direction as needed in addition to demonstrating to them how and where I found the source for the question to further increase their knowledge.
Wellmed Medical ManagementSan Antonio, TX
Utilization Management – Subject Matter Expert (SME)
11.2019 - 07.2021
Job overview
- Front line support for providers calling to see if certain DX codes are required to run a Prior Authorization
- We run the codes and either create the authorization or inform the provider one will not be required at this time
- Also, take requests via fax as well and build those as needed
- I am currently a Subject Matter Expert (SME) in my role where after my time on the phone, I spend the other half of my shift assisting other advocates with correct procedures and questions if they are needing assistance.
Centene CorporationSan Antonio, Texas
Customer Service Representative II
08.2017 - 07.2019
Job overview
- Members call in asking about their benefits regarding their Medicare Replacement plan
- Can take my time with them and carefully explain all of their options and benefits so they have a full understanding of everything the plan offers
- I pride myself on educating each person as much as possible, so they always remember calling in
- With many members, I took my time answering all their questions because the more I assisted them, the higher chance they have of not having to call back which saves the company money on resources that can be used for other members who need it.
AetnaSan Antonio, Texas
Consumer Marketplace Representative
09.2015 - 07.2017
Job overview
- Advised and assisted members regarding their plan with the Affordable Care Act
- Each member is always a different experience, and everybody has different needs
- Over the phone, answered any questions they had regarding the plan and coordinated with providers as well as other insurance agencies to truly assist the member and make sure my experience with them always stood out
- I had a member who had an issue with a claim for months and months and I would consistently ask this member to call me if need be
- After months of figuring out issue, member even wanted to send me a Christmas card and said he would be a loyal AETNA customer for life
CHRISTUS Santa Rosa Hospital - Westover HillsSan Antonio, Texas
Patient Access Registrar
10.2014 - 04.2015
Job overview
- Went to each room and spoke with patient regarding registering for the hospital
- While collecting copayments and due balances, developed a connection with each patient and assured them they were in great hands at the hospital, as I can't think of anybody who doesn't get nervous while being treated at a hospital
- I always attempted to put myself in the patient's position
CitibankSan Antonio, Texas
Fraud Supervisor
06.2012 - 04.2014
Job overview
- Assisted customers discussing possible debit card fraud
- Many people would call in very frustrated that their card was declined due to us possibly catching a fraud pattern
- Other customers called in angry we didn't catch the fraud pattern
- Many customers also praised us for catching it and preventing any more fraud from happening
- As a fraud victim myself years ago, I always shared my story with them of what happened to me, and I truly believe everybody deserves empathy and compassion
Education
Northwest Vista College
Associates of Liberal Arts
05.2019
Skills
- Regulatory Compliance
- Performance monitoring
- Key Performance Indicators
- Operations Management
- Quality Control
- Performance Improvement
- Talent Acquisition
- Coaching and Mentoring
- Employee engagement
- Diversity and Inclusion
- Complaint resolution
- Workplace Safety
Personal Information
Hobbies: I love reading and educating myself. I read both fiction and nonfiction books regarding religion, politics, and science.
References
- Tanaya Blake, 425 330 7960
- Vanessa Diaz Stevenson, 914 323 8752
Timeline
Supervisor
Optum Care
12.2022
Team Lead
Optum Care
08.2021 - 12.2022
Utilization Management – Subject Matter Expert (SME)
Wellmed Medical Management
11.2019 - 07.2021
Customer Service Representative II
Centene Corporation
08.2017 - 07.2019
Consumer Marketplace Representative
Aetna
09.2015 - 07.2017
Patient Access Registrar
CHRISTUS Santa Rosa Hospital - Westover Hills
10.2014 - 04.2015
Fraud Supervisor
Citibank
06.2012 - 04.2014
Northwest Vista College
Associates of Liberal Arts
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