Open To Work
Verified
This profile is verified using an email address.
Carolina Sanchez
Tampa,FL
Summary
- 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.
- WORK EXPERIENCE: Offering over 23 years of experience in the Healthcare Industry, both in English & Spanish, back and front office. Insurance Verifier -Provider/Patient Services Advocate. Prior insurance experience: Medicaid/Medicare, among other Insurance Plans.
- Over 3 years of experience with small business owners who receive access to over 30 traditional bank loans, financing specialized equipment leases/financing or loans across a large network of commercial and online financial institutions. Financial services for small business loans and equipment finance contracts, with the ability to work effectively in a fast-paced environment as a positive, energetic team player.
- Strong attention to detail. Able to notate customer issues accurately during the call in the provided format with excellent command of both languages. Customer service professional with a consistent record of delivering high-quality support and resolving customer concerns promptly.
- Computer literate: MS Word; able to type 40-45 WPM. 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.
Customer service specialist with a strong focus on team collaboration and achieving results. Demonstrated ability to handle diverse customer inquiries, resolve issues efficiently, and adapt to changing needs. Skilled in communication, problem-solving, and maintaining positive customer relations. Reliable team player who consistently delivers high-quality service.
Overview
17
17
years of professional experience
Work History
Customer Service Representative Specialist
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.
- Processed payments, payoff requests, and routine account adjustments using servicing systems.
Remote Service Advocate III for the MRU
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 on time
Navigated all applications supporting thorough research and delivery of accurate information to our providers; researched and delivered updated information to providers. - Supported workflow priorities by balancing high-volume inquiries and urgent escalations.
- Coordinated cross-functional follow-up to accelerate issue resolution and service recovery.
Customer Service Representative Specialist
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.
- Provided ongoing support to teammates, fostering a collaborative environment that improved overall team performance.
Clinical Administrative Coordinator
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
Cardinal Health ERecovery, Lead Representative
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.
- Ensured compliance with industry regulations by developing and enforcing policies and procedures across the organization.
- Collaborated with clinical and administrative teams to improve patient access, handoffs, and operational efficiency.
- Resolved patient inquiries, billing concerns, and scheduling issues with timely, professional communication.
- Verified insurance eligibility, authorizations, and referral requirements to support compliant patient intake.
Education
High School Diploma -
06.1992
Some College (No Degree) -
Diploma - undefined
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
- LeaseWorks SOR Asset Equipment Management NLS SOR Nortridge Loan Management Software Salesforce, Infosend Online Bill Pay Solution ISSI Claim Processing System Blue Square Siebel Systems Diamond Quest PAIS EIP 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 - 09.2026
Remote Service Advocate III for the MRU - Glidewell -Blue Cross Blue Shield of Florida
08.2020 - 12.2021
Customer Service Representative Specialist - Custom Mobility
05.2018 - 02.2020
Clinical Administrative Coordinator - Bayfront Health Hospital St. Petersburg
03.2017 - 12.2017
Cardinal Health ERecovery, Lead Representative - Trinitas Regional Medical Center, St. Joseph's Regional Medical Center, University Hospital
02.2010 - 12.2015
Hackensack School of Business - Diploma,
Grover Cleveland, H.S. - High School Diploma,
Eastwick College - Some College (No Degree),