Carmen Berrios
Yulee,FL
Summary
Compassionate Medical Customer Service Representative with a proven track record of high productivity and efficient task completion. Skilled in patient communication, accurate data entry, and healthcare policy understanding. Known for empathy, active listening, and problem-solving to drive patient satisfaction and support team goals.
Overview
20
20
years of professional experience
1
1
Certification
Work History
Insurance Specialist
Advanced Endodontics
Clermont, FL
05.2016 - 10.2023
- Enhanced customer satisfaction by addressing insurance-related inquiries and resolving issues promptly.
- Processed eligibility and benefits verification and authorization requests.
- Managed denials, late payments, and extensions
- 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
Clermont, FL
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
Longwood, FL
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
Winter Park, FL
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
Orlando, FL
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
Winter Park, FL
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 Processing Expertise
- Client Support
- Policy Knowledge
- Claims reporting systems
- Health insurance
- Vision and dental insurance
- Customer follow-up
- Analytical Problem Solving
- Insurance Coverage Verification
- Customer Issue Resolution
- Customer billing
- Data Entry
- Insurance Practices
- Records Maintenance
- Insurance Eligibility
- Insurance Claim Regulations
- Claims Information Gathering
Bilingual English and Spanish
Languages
Spanish
Native/ Bilingual
Certification
- Public Notary
- HIPAA certification
Accomplishments
Magna Cum Laude
Timeline
Insurance Specialist
Advanced Endodontics
05.2016 - 10.2023
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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