Open To Work
CAROLINA SANCHEZ
Orion First Financial - Concord Servicing, LLC
Tampa,FL
Bilingual: English/Spanish. Ability to translate accurately and effectively from English into Spanish and vice versa. Strong organizational skills and demonstrated ability to work independently and manage multiple project priorities. Strong analytical and problem-solving skills, close attention to detail, excellent command of both languages, and outstanding writing skills. Computer literate: MS Word, Word Perfect, PowerPoint, Outlook, Excel. Superb capacity to communicate effectively with individuals from a wide range of cultures. Active listening/verbal and written communication skills. Ability to multitask between systems while communicating with the customer and documenting the account within the appropriate database. Ability to handle escalated calls to resolve issues with professionalism and patience. Ability to grasp operational concepts/objectives and follow routing procedures using appropriate judgment. Able to type 40-45 WPM. WORK EXPERIENCE: Offering over 19 years of experience in the Healthcare Industry, both in English & Spanish, back and front office. Insurance Verifier -Provider/Patient Services Advocate. Ability to work effectively in a fast-paced environment with a positive, energetic team player; values highly complex organizations. Prior insurance experience: Medicaid/Medicare among other Insurance Plans. Ability to work effectively in a fast-paced environment with a positive, energetic team player; values highly complex organizations. Prior insurance experience: Medicaid/Medicare among other Insurance Plans. Ability to establish and maintain positive and effective work relationships with coworkers, clients, members, providers, and customers. Strong interpersonal skills. Interested in working with people, with a strong desire to resolve problems. Able to work under pressure. Strong attention to detail. Able to notate customer issues accurately during the call in the provided format.
23
Years of experience
Work History
Customer Service Representative Specialist
3 Years 1 Month
Orion First Financial - Concord Servicing, LLC - Scottsdale, AZ | 08.2023 - 09.2026
- Provided accurate payoff amounts and account balances; processed insurance, payment, refund, and title management requests; and maintained daily account documentation.
- Partnered with teams to streamline processes and improve the client experience.
- Supported 30+ bank clients with customer service for small business equipment finance loans.
- Reviewed loan accounts and Equipment Finance Agreements (EFAs) for accurate servicing and documentation.
- Evaluated insurance information from Great American Insurance Group (GAIG) against required coverage standards.
- Contacted customers regarding overdue balances and Personal Property Tax (PPT) and helped resolve delinquent accounts.
- Processed applicable fees, ACH payment updates, and account changes while maintaining accurate loan records.
- Addressed financial account inquiries by inbound and outbound phone calls, email, and live chat.
- Investigated billing discrepancies and payment concerns while safeguarding confidential customer information.
- Reviewed reports, supported account closures, and issued paid-in-full letters and title releases.
- Documented customer interactions and managed account records using Salesforce, CRM systems, Lease Works, NLS SOR, and Excel.
Customer Service Representative Specialist
1 Year 9 Months
Custom Mobility - Largo, FL | 05.2018 - 02.2020
- Bilingual Proficient Fluency Spanish & English-Speaking Customer Service Expertise
- Translator for the entire company's departments
- Responsibilities in the Customer Service Department include:
- Taking calls from clients and confirming current information or creating new client files.
- Updating client's account information for various department
- Insurance Verification through Portals and Eligibility sites
- Following an intake format to make sure all relevant information is gathered at the time of the call.
- Accurate data entry of client information, appointment dates, related notes, etc.
Clinical Administrative Coordinator
9 Months
Bayfront Health Hospital St. Petersburg - Saint Petersburg, FL | 03.2017 - 12.2017
- Provided support to the Case Management staff performing non-clinical activities and supporting the management of the department. Protected the confidentiality of member information and adheres to company
- Initiated clinical review requests to the Utilization Reviewer Case Managers
- Strong customer service skills in coordinating service delivery including attention to members/customers, sensitivity to concerns, proactive identification, and resolution of issues to promote positive outcomes for members
- Maintained compliance with the track denials management system
- Coordinated initiatives relative to the evaluation, processing, and handling of insurance claims
- Managed Case Management Team activities related to denial and recoupment issues
- Prepared decision support data reports for physician and hospital quality/utilization meetings
- Assisted the Case Management Team in providing in-service training to hospital staff related to payer activities
- Communicated with insurance representatives regarding admissions, authorizations, and denials
- Provided secretarial support to the care coordination office for the operation of daily activities
- Scheduled meetings with customers, staff, and physicians to discuss medical issues
- Escalated requests for extensive clinical review or denial
Remote Service Advocate III for the MRU TEMP-PROJ.
1 Year 4 Months
Glidewell -Blue Cross Blue Shield of Florida - Jacksonville, FL | 08.2020 - 12.2021
- The Customer Service Advocate provides service excellence by accurately examining, researching, and effectively communicating information to our providers. The Customer Service Advocate maintains a professional relationship with multiple internal Florida Blue partners by interacting and coordinating to ensure positive business results and relationship building. Provide excellent customer service to our providers by sending Medical Record Requests and ensuring they are timely.
Communicate effectively to ensure customers understand the Company's products and services
Perform thorough research using multiple systems.
Track and Resolve cases timely
Navigates all applications supporting thorough research and delivery of accurate information to our providers,researched and delivered updated information to providers.
Cardinal Health eRecovery, Lead Representative
5 Years 10 Months
Trinitas Regional Medical Center, St. Joseph's Regional Medical Center, University Hospital - Newark - Elizabeth, NJ | 02.2010 - 12.2015
- Managed applications to pharmaceutical manufacturers' "Patient Assistance Programs" for the recovery of drugs administered/dispensed to indigent cancer patients without third party
- Maintained security and confidentiality of patient information related to the functions and activities of the medication recovery program for the month-end report
- Liaison to doctors, patients, and pharmaceutical companies between the hospital, insurance providers, and case managers regarding coverage status
- Verified physician's credentials prior to submission of enrollment forms to drug companies.
- Verified patient billing information with Medicaid & Medicare along with State insurance coverage according to hospital policy prior to submission of enrollment to drug companies.
- Ensured the practice MD possesses credentialing.
Education
High school diploma
Grover Cleveland, H.S.
Diploma
Eastwick College
Diploma
Hackensack School of Business
01.2003
Skills
Bilingual – Fluent English/Spanish -Read/Write Spanish and English fluently. Face-to-Face & Telephonic Interpreter
Over 19 years in the Healthcare Industry. Detail-oriented and focused on accuracy and efficiency. Account Payables/Account Receivables Customer Service Expert Bilingual -Fluent Spanish & English Medical Records Reviewer Medical Terminology Auditing Insurance Verification
System Experience
ISSI Claim Processing System | Blue Square | Diamond | Quest | PAIS | EIP | Seibel | Provider Connect | PAI (Patient Access Intelligence | PAS | MS Office (Word
Outlook
Excel).
Timeline
Customer Service Representative Specialist
Orion First Financial - Concord Servicing, LLC
08.2023 - 09.2026Read more
Remote Service Advocate III for the MRU TEMP-PROJ.
Glidewell -Blue Cross Blue Shield of Florida
08.2020 - 12.2021Read more
Customer Service Representative Specialist
Custom Mobility
05.2018 - 02.2020Read more
Clinical Administrative Coordinator
Bayfront Health Hospital St. Petersburg
03.2017 - 12.2017Read more
Cardinal Health eRecovery, Lead Representative
Trinitas Regional Medical Center, St. Joseph's Regional Medical Center, University Hospital
02.2010 - 12.2015Read more
Grover Cleveland, H.S. - High school diploma,
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Eastwick College - Diploma,
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Hackensack School of Business - Diploma,
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