Cindy Flores
Summary
Hardworking career healthcare employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience in an often frustrating and fragmented healthcare ecosystem.
Overview
13
13
years of professional experience
Work History
Benefits Verification Rep/Claims Processor
CVS Healthcare Remote
10.2022 - Current
- Conducted verification of members' pharmacy benefits using Sure Scripts and People Safe
- Updated members' insurance information, ensuring accurate bill group, effective date, and primary relationship
- Notified members of copay details and offered copay assistance
- Verified copay assistance funds and maintained updated accounts with correct CPA information
- Ran test claims to determine processing viability
- Obtained verbal consent from Medicare members for RCC application, managing the corresponding paperwork
- Executed multiple procedures to rectify rejections using source, BV Tools, and SharePoint
- Liaised with the helpdesk to secure max dollar overrides on cost-exceeds-max rejections
- Initiated prior authorizations through Cover My Meds
- Achieved multiple perfect scores (100) in call quality
- Answered incoming calls from CCR reps, PSR, and escalation reps, diligently working on tasks to find optimal solutions for members.
Patient Access
Aerotek Staffing Agency (Vista Health Systems)
Lindenhurst, IL
04.2021 - 10.2022
- Entered patient demographics, insurance, and financial information accurately
- Verified insurance eligibility through Passport
- Calculated patient copays, deductibles, or self-payments, collecting amounts due
- Obtained necessary signatures on consent forms, HIPPA forms, and Medicare forms.
3rd Shift Escalations Agent/Dispatcher
Ansercall24/TAS United - Remote
San Antonio, TX
12.2016 - 03.2021
- Managed multiple incoming phone lines from hospitals, physicians, and management
- Appropriately dispatched calls and messages via paging system, secure message, text, or email
- Accurately collected required demographic information
- Triage calls to determine proper escalation.
Patient Registrar
Aerotek Staffing Agency (Alexian Brothers Behavioral Health Hospital)
Hoffman Estates, IL
03.2016 - 08.2016
- Entered patient demographics, insurance, and financial information accurately
- Verified patient authorization and correct documentation
- Calculated patient copays, deductibles, or self-payments
- Collected any prior balances patients may have.
Medical Receptionist
Foot and Ankle Treatment Center
Glenview, IL
09.2010 - 09.2011
- Registered patients and managed check-ins/check-outs
- Verified insurance, benefits, and deductibles
- Collected copays, payments on accounts, and balanced daily transactions at the end of the business day.
Skills
- Customer Service
- Data Entry
- Insurance Coverage Verification
- Outstanding Clerical Abilities
- Appointment Scheduling
- Patient Rapport
- Background in Insurance
- Insurance Terminology
Timeline
Benefits Verification Rep/Claims Processor
CVS Healthcare Remote
10.2022 - Current
Patient Access
Aerotek Staffing Agency (Vista Health Systems)
04.2021 - 10.2022
3rd Shift Escalations Agent/Dispatcher
Ansercall24/TAS United - Remote
12.2016 - 03.2021
Patient Registrar
Aerotek Staffing Agency (Alexian Brothers Behavioral Health Hospital)
03.2016 - 08.2016
Medical Receptionist
Foot and Ankle Treatment Center
09.2010 - 09.2011
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