Cecilia Bautista-Pena
Homestead
Summary
Dynamic bilingual customer service professional with a focus on insurance eligibility verification and patient support advocacy. Expertise in problem resolution and relationship management enhances customer satisfaction while meeting performance targets. Strong analytical thinking and communication skills drive operational efficiency.
Overview
25
25
years of professional experience
Work History
BILINGUAL NEMT CSR
Alivi Health
Miami
05.2025 - Current
- Handled high volumes of outbound calls and managed inbound inquiries, facilitating effective communication and resolution.
- Interacted daily with health plan representatives, providers, and members for effective communication.
- Assigned trips to transportation providers, optimizing service delivery based on geography, mobility, and capacity.
- Monitored provider services, ensuring compliance with SLAs, KPIs, and safety standards to maintain service quality.
- Resolved issues related to trip assignments for transportation partners.
- Maintained awareness of company contacts and roles for improved collaboration.
- Processed and maintained logistics reporting through accurate data entry.
- Performed CSR duties to meet call volume demands and achieve service metrics.
Contact Center Associate 1
UHealth Connect
Remote
05.2024 - Current
- Scheduled and registered patients for appointments within University of Miami Health System.
- Utilized EPIC scheduling system to efficiently search for appointments across multiple specialties.
- Ensured appropriate provider scheduling by applying medical triage expertise and insurance knowledge.
- Supported medical school's vision by facilitating patient-centric access to quality care.
- Provided general information about University of Miami Health System services to patients and providers.
- Completed full registration for appointment requests, adhering to policies and procedures.
- Verified demographic and insurance information for accuracy prior to appointments.
- Maintained compliance with HIPAA standards regarding patient privacy and confidentiality.
KForce for the DCF (department of child and family)
Kforce
Miami
05.2023 - 11.2023
- Meet and exceed daily productivity goals, including managing a high call volume and consistently earning top quality assurance satisfaction scores
- Answer inbound calls, assist callers with registrations, provide all required information to caller to complete their case; like what specific documentation is needed or missing, assisting callers in creating an online account to allow them to receive and upload documents as well as check their statuses
- Handled document validation, opening specific assigned cases and verifying that all information is correct and required documentation is in file.
Bilingual Customer Service Representative
KForce (FEMA) ( Contractor-Seasonal)
Remote, Miami
07.2022 - 04.2023
- Supported FEMA in coordinating emergency support operations
- Resolved callers' inquiries regarding local or state emergencies following Hurricane Ian.
Customer Service Care Coordinator
United Healthcare
Remote, Miami
02.2021 - 12.2022
- Serve as a single point of contact for the customer providing concierge and white glove level service, removing burdens, providing end-to-end resolution, and anticipating their future healthcare needs or potential opportunities to improve the experience
- Research complex issues like claims and authorizations, across multiple applications like Maestro, Clinical Profile, ICUE, GPS, Knowledge Central, to own the resolution of all customer issues in real time or through comprehensive and timely follow-up with members
- Identify gaps in processes and work closely with other departments for process improvement
- Meeting or exceeding all the performance goals established for the position in the areas of efficiency, call quality, customer satisfaction, first call resolution and attendance since June 2021, always achieving my quarterly bonus
- Remarkable metrics leading my team placing first in UES, Nav Sat and Annual Wellness Visits
- Placed second in DAA and Average Outbound Call, Winning “THE GOAT Award in different months
- Team Lead for a few weeks and POC several times.
Bilingual Customer Service Representative
Florida Department of Economic Opportunity (Remote
Miami
04.2020 - 08.2020
- Delivered bilingual customer service in English and Spanish, assisting diverse clients with inquiries and issues.
- Managed call center operations, handling phone calls, chats, and self-service tickets while documenting customer interactions.
- Fast paced, high volume, potentially emotionally charged environment (callers may be frustrated, emotional)
- Customer is Florida’s Department of Economic Opportunity (DEO) where calls are received from Florida residents regarding their unemployment claims
- Consultants will be initially doing Pin Resets and/or supporting the FAQ line
- As consultants become seasonal, they may be trained to do more.
Bilingual Customer Service Representative
Visa, INC
Miami
09.2014 - 01.2020
- Respond to inbound telephone calls and may generate outbound calls regarding information on aspects of multiple Visa products
- Evaluate the nature of each call and determine the appropriate action to complete the call
- Answered general customer service questions from cardholders and explained multiple program features.
- Adhere to established Client Support Services’ procedures and guidelines while providing quality customer service to meet and exceed department standards
- Provide general information and support on any VISA related topic or product and direct the customer accordingly
- Use several computer programs to respond to customer inquiries
- Document cases to show action taken
- Serve as escalation point for calls requiring advanced knowledge of product line
- Act as peer mentor to customer service associates
- Respond to incoming customer requests quickly, proficiently and professionally while meeting specific quality expectations
- Listened actively and probed to identify call nature and determine appropriate actions for resolution
- Multi-task across several computer programs to respond to customer inquiries
- Utilized tools to support, document, and address customer inquiries effectively
- Collaborated with peers to assist cardholders and foster an inspiring environment for both customers and team members
- Compliance with Key Control and other policies, including maintaining confidentiality in our secure environment
- Demonstrated commitment to quality and customer service based on the customer’s needs
- Excellent verbal and written communications, interpersonal skills, customer orientation, team interaction, problem solving, and multi-tasking skills required
- Efficiency, accuracy, and attention to detail
- Computer experience within Windows environment as well as the ability to navigate the internet, utilize computer shortcut functions, and navigate through multiple program platforms
- Knowledge of the payments business preferred
- Ability to learn and adjust quickly to changes in process
- Foster a positive work environment
- Know how to escalate issues related to customer inquiry or other in a timely and appropriate manner.
- Handled sensitive customer data with care to ensure confidentiality and compliance.
- Maintained confidentiality of customer information in compliance with company policies.
Receptionist
Gamma Maintenance and Staffing
Miami
01.2010 - 08.2014
- Performed receptionist duties at front desk
- Answered and screened telephone calls, directing them to appropriate staff
- Provided accurate information to callers, enhancing communication
- Greet persons entering the organization
- Direct persons to the correct destination
- Ensure knowledge of staff movements in and out of the organization
- Provide general administrative and clerical support
- Prepare correspondence and documents
- Receive and sort mail and deliveries
- Maintained appointment diary, ensuring efficient scheduling of meetings
Customer Sales and Service Expert
AT&T
Miami
01.2009 - 12.2009
- Handled billing, service, and sales inquiries from customers in a call center environment, ensuring accurate and timely resolutions.
- Recommended products and services aligned with customer needs and business goals, enhancing customer satisfaction and driving sales.
- Took ownership of customer requests, facilitating successful outcomes through effective problem-solving and responsible escalation when necessary.
- Provided customer support in both English and Spanish
- Building professional rapport with the customer by listening to understand and being clear and articulate in your verbal and written communications
- Effectively communicate information, minimizing the need for future contacts
- Interpreted and translated information regarding products, services, and policies for customers.
Bilingual Sales Associate
PRC LLC
Miami
03.2006 - 10.2008
- Sales Consultant for MAS (DTV Sales)
- Ensured that performance was always above client goals and expectations. often being part of the top 10 agents in the DTV Sales account.
- Converted calls into sales while delivering exceptional customer service and achieving one call resolution.
- Supported my team manager as a lead agent providing floor support, monitoring the queues and taking over all escalated supervisor calls
- Monitored calls for my low-performing peers to help them improve their performance with constructive feedback resulting in immediate improvement in their performance
- Supported the nesting process by answering questions, providing feedback, and ensuring that new agents develop good product knowledge
- Utilized CMS software daily to manage client information and track interactions.
- Able to run real-time and historical reports to monitor agents’ performance
- Applied quality assurance scanning techniques to ensure compliance with standards.
- Supported the administrative team with their quarterly audits for ID maintenance
Paralegal
Corte Suprema de Justicia
Santo Domingo
09.2001 - 07.2003
- Provided comprehensive case reporting records to the supreme Judge, ensuring accurate and timely information delivery
- Screened all parties involved in the case, including witnesses, attorneys, and the defendant, to facilitate thorough case preparation
- Assisted attorneys in legal research and document preparation, enhancing the quality and effectiveness of case presentations
- Ability to interact with all levels within the justice system.
Education
Medical Billing And Coding Specialist - Medical Billing And Coding Specialist
Florida Technical College
Miami, FL07-2023
Bachelor's degree in Law - Law
Universidad Catolica Santo Domingo
Santo Domingo, Dominican Republic09-2003
Skills
- Insurance Eligibility Verification
- Advanced Customer Support
- Client Scheduling Management
- CRM software
- Medical terminology proficiency
- Service Quality Assurance
- Patient Support Advocacy
- Phone engagement
- Live support assistance
- Analytical Problem-Solving
- Information Gathering
- Complaint resolution
- Attention to detail
- Effective Interpersonal Communication
- Verbal communication
- Written communication
- Strong teamwork
- Patient Support Advocacy
Primaryskills
- Interact well with others
- Proficient in the use of all Microsoft Windows based programs and Internet browsing
- Fluent in Spanish and English – written and spoken
- Possess excellent leadership skills
- Self-efficient, detail-oriented, highly organized
- Strong analytical and problem-solving skills
- Proficient in Microsoft Office and Power Point
- Experience in over the phone sales
- Experience in outbound/inbound call center
- Fundamental customer service/satisfaction knowledge
Timeline
BILINGUAL NEMT CSR
Alivi Health
05.2025 - Current
Contact Center Associate 1
UHealth Connect
05.2024 - Current
KForce for the DCF (department of child and family)
Kforce
05.2023 - 11.2023
Bilingual Customer Service Representative
KForce (FEMA) ( Contractor-Seasonal)
07.2022 - 04.2023
Customer Service Care Coordinator
United Healthcare
02.2021 - 12.2022
Bilingual Customer Service Representative
Florida Department of Economic Opportunity (Remote
04.2020 - 08.2020
Bilingual Customer Service Representative
Visa, INC
09.2014 - 01.2020
Receptionist
Gamma Maintenance and Staffing
01.2010 - 08.2014
Customer Sales and Service Expert
AT&T
01.2009 - 12.2009
Bilingual Sales Associate
PRC LLC
03.2006 - 10.2008
Paralegal
Corte Suprema de Justicia
09.2001 - 07.2003
Medical Billing And Coding Specialist - Medical Billing And Coding Specialist
Florida Technical College
Bachelor's degree in Law - Law
Universidad Catolica Santo Domingo