Carmen Berrios
Yulee,FL
Summary
Passionate and skilled in customer care, support, and logistics, dedicated Customer Service Representative with expertise in responding to customer complaints and finding effective solutions. Excels in managing customer requests and providing insightful product analysis. Specializes in facilitating customer satisfaction through seamless connections and clear communication channels.
Overview
18
18
years of professional experience
Work History
Insurance Specialist
Advanced Endodontics
05.2016 - 10.2021
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Followed up on denials, late payments, extensions and other special circumstances.
- Tracked pending authorizations to resolve discrepancies and avoid revenue loss.
- Reduced claims processing time by effectively collaborating with adjusters, claimants, and internal departments.
- Streamlined policy management by regularly updating client information and tracking policy changes.
- Communicated effectively with members of operations, finance, and clinical departments.
Medical Front Desk Receptionist
Eye Express
08.2012 - 10.2016
- Welcomes patients and visitors by greeting patients and visitors, in person or on the telephone, answering or referring inquiries
- Optimizes patients' satisfaction, provider time, and treatment room utilization by scheduling appointments in person or by telephone
- Keeps patient appointments on schedule by notifying provider of patient's arrival; reviewing service delivery compared to schedule; reminding provider of service delays
- Comforts patients by anticipating patients' anxieties; answering patients' questions; maintaining the reception area
- Ensures availability of treatment information by filing and retrieving patient records
- Maintains patient accounts by obtaining, recording, and updating personal and financial information
- Obtains revenue by recording and updating financial information; recording and collecting patient charges; controlling credit extended to patients; filing, collecting, and expediting third-party claims
- Protects patients' rights by maintaining confidentiality of personal and financial
- Maintains operations by following policies and procedures; reporting needed changes
- Contributes to team effort by accomplishing related results as needed.
Bilingual Customer Service Receptionist
Primoris Services
04.2010 - 02.2012
- Use computers for various applications, such as database management or word processing
- Collect and deposit money into accounts, disburse funds from cash accounts to pay bills or invoices, keep records of collections and disbursements, and ensure accounts are balanced
- Create, maintain, and enter information into databases
- Set up and manage paper or electronic filing systems, recording information, updating paperwork, or maintaining documents, such as attendance records, correspondence, or other material
- Operate office equipment, such as fax machines, copiers, or phone systems and arrange for repairs when equipment malfunctions
- Greet visitors or callers and handle their inquiries or direct them to the appropriate persons according to their needs
- Coordinate conferences, meetings, or special events, such as luncheons or graduation ceremonies
- Arrange conference, meeting, or travel reservations for office personnel
- Open, read, route, and distribute incoming mail or other materials and answer routine letters
- Establish work procedures or schedules and keep track of the daily work of clerical staff
- Learn to operate new office technologies as they are developed.
Bilingual Phone Operator/Tech Support
American Safety Council
10.2006 - 02.2010
- Placing orders for office supplies, booking meetings, and greeting clients
- Keep records of customer interactions, transactions, recording details of inquiries, complaints, comments, actions taken
- Educate customers with billing information regarding their account
- Process credit cards, checks, and money orders online
- Take payments over the phone and updating information on insured's account when needed
- Answer multiple phone lines and directing incoming calls to the appropriate department.
Customer Service Representative
Cleartel Communications
02.2004 - 09.2006
- Manage large amounts of inbound and outbound calls in a timely manner
- Follow communication 'scripts' when handling different topics
- Identify customers' needs, clarify information, research every issue, and provide solutions and/or alternatives
- Seize opportunities to upsell products when they arise
- Build sustainable relationships and engage customers by going the extra mile
- Keep records of all conversations in our call center database in a comprehensible way
- Frequently attend educational seminars to improve knowledge and performance level
- Meet personal/team qualitative and quantitative targets.
Phone Operator/Language Interpreter
Optimal Phone Interpreters
10.2003 - 02.2006
- Provided language services and performed language-specific translations
- Handled and responded to phone calls from clients in client-specific languages
- Developed and maintained customer portfolio and customer relationships
- Conducted community outreach activities and performed qualitative and detailed interviews
- Interpreted and translated technical terminology and colloquial language.
Education
Master Of Science - Healthcare Administration
Herzing University
Dearborn, MI12.2023
Bachelor Of Science - Health Care Administration
Herzing University
Dearborn, MI12.2022
Associate of Science in Healthcare Administration -
Herzing University
Madison, WI04.2021
Skills
- Documentation skills
- Policy analysis
- Documentation abilities
- Account Management
- Insurance law knowledge
- Reporting skills
- Financial Planning
- Claims Management
- Customer Service
- Policy Knowledge
- Claims reporting systems
- Health insurance
- Vision and dental insurance
- Customer follow-up
- Critical Thinking
- Insurance Coverage Verification
- Customer Complaint Resolution
- Customer Billing
- Data Entry
- Insurance Practices
- Records Maintenance
- Insurance Eligibility
- Insurance Claim Regulations
- Claims Information Gathering
Bilingual English and Spanish
Skillcompetencies
- Knowledgeable of Microsoft Programs, Work, Excel, and PowerPoint
- Customer Service skills including telephone skills and interpreter skills
- Fluent in English and Spanish
- Time Management
- Judgment and Decision Making
Languages
Spanish
Native or Bilingual
English
Native or Bilingual
Timeline
Insurance Specialist
Advanced Endodontics
05.2016 - 10.2021
Medical Front Desk Receptionist
Eye Express
08.2012 - 10.2016
Bilingual Customer Service Receptionist
Primoris Services
04.2010 - 02.2012
Bilingual Phone Operator/Tech Support
American Safety Council
10.2006 - 02.2010
Customer Service Representative
Cleartel Communications
02.2004 - 09.2006
Phone Operator/Language Interpreter
Optimal Phone Interpreters
10.2003 - 02.2006
Master Of Science - Healthcare Administration
Herzing University
Bachelor Of Science - Health Care Administration
Herzing University
Associate of Science in Healthcare Administration -
Herzing University
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