Claryvette Garcia
Clearwater,U.S.
Summary
Motivated professional with a strong work ethic and proven adaptability. Demonstrates exceptional interpersonal skills and excels in customer service, multitasking, and time management. Experienced in working independently and mastering new skills quickly. Committed to delivering positive customer experiences and contributing to organizational success.
Overview
18
18
years of professional experience
Work History
Advanced Medical Support Assistant (Community Care)
Department of Veterans Affairs
Bay Pines, FL
06.2024 - 06.2025
- Assists Veterans with scheduling appointments with clinical providers.
- Follow-up after appointment to ensure attendance, and check-up for additional procedures.
- Informs providers in any change to patient's Community Care medical appointment.
- Prepares medical documentation for scanning into Veteran's electronic medical record.
- Regular meetings with supervisor and Community Care Nurses to manage and coordinate patient care.
- Schedules appointments and processes authorizations utilizing HSRM, CTM, CPRS, DST, Consult Toolbox.
- Guides patients through the Community Care programs, inputs referrals, sends authorizations, documents complaints, and provides follow-up and suggests resolutions to supervisor.
- Interprets and applies a complex body of pertinent laws, regulations, directives, and policies that relate to the administration of VA Healthcare Benefits and Community Care Eligibility.
- Performs other related duties as assigned.
- Veterans Health Administration
National Account Manager
ADT Security
Largo, FL
07.2023 - 06.2024
- Support Account Managers and Lead Account Managers.
- Coordinate with National Account Managers, local branches and authorized subcontractors to perform site surveys and assist with preparation of sales paperwork (proposals, bid packages, permits, contracts, etc.).
- Assist Account Managers with presentations to potential customers explaining the operation of their equipment and applicable services.
- Coordinate with National Account Managers, local branches and authorized subcontractors to perform site surveys and assist with preparation of sales paperwork (proposals, bid packages, permits, contracts, etc.).
- Assist Sales and Design Team in creating bid packages.
- Create or help create sales documents.
- Assist with mailing and faxing as necessary.
- Assist in coordinating the installation, service, and billing of National Account Customers.
- Work with the branches and Monitoring department to research and resolve customer issues.
- Ensure that all customer correspondence is responded to or forwarded to the appropriate department within 24 hours of receipt in the department.
- Prepare formal correspondence in response to customer's questions or concerns.
- Assist in handling customer escalations.
- Pull Mastermind data for Account Managers and Sales Team.
- Assist tracking statistical information as needed for the department and compile data into reports that are submitted to management in a timely manner.
- Assist in acquiring required permits.
- Perform all other duties and projects as assigned.
Quality Control Technician
Chromalloy
Oldsmar, FL
03.2022 - 07.2023
- Provide quality control, final inspection support, and shipping / receiving inspection support.
- Accurately interpret engineering drawings, customer specifications, company specifications, sampling procedures, designs, forms, and instructions for recording, evaluating, and reporting quality and reliability data.
- Utilize precision tools and equipment with accuracy for testing and measurement of product.
- Recommends modifications of existing quality or production standards to achieve optimum quality within limits of equipment capability.
Payee Provisioning Team Leader
Zelis Healthcare
Remote, FL
09.2021 - 03.2022
- Supporting agents with live calls.
- Escalation calls.
- Ability to work independently without supervision and provide excellent customer service while adhering to department's productivity and quality metrics.
- Making sure provider enrollment forms and deposit inquiries contain all necessary and appropriate information.
- Assist in verifications to limit fraud loss.
- Review daily reports and data entry forms to identify accounts that need maintenance or verification.
- Respond to basic questions by phone or email about Zelis products and services, forward escalated issues to the appropriate team or supervisor.
- Adhere to Zelis Payments standard and policies to ensure client privacy.
Payment Operations Specialist
Zelis Payments
Remote, FL
08.2020 - 09.2021
- Research and resolution.
- Assisting providers with any issues or concerns that they may have about products or processes via email communications.
- Make outbound calls as needed.
- Assist providers in signing up for payer sponsored direct EFT product as well as assisting with registration process, web portal set up and provider portal questions and work to resolve any outstanding issues.
- Escalating complicated cases as needed.
- Opening/monitoring tickets via JIRA.
- Maintain awareness of and ensure adherence to Zelis Payments standards regarding privacy.
Client Service Representative
Zelis Payments
Clearwater, FL
05.2019 - 08.2020
- Responsible for building and maintaining outstanding relationships with providers and payers and addressing any issues or concerns that they may have about products or processes.
- Field incoming calls and make outgoing calls to medical providers and payers to answer any questions they may have regarding new and on-going payment and data processes.
- Work to resolve any outstanding issues, explain use of electronic payment options (credit cards, direct EFT).
- Assist providers in signing up for direct EFT product as well as assisting with registration process, web portal set up and provider portal questions.
- Maintain awareness of and ensure adherence to Zelis Payments standards regarding privacy.
Fraud Detection Lead
PSCU
Saint Petersburg, FL
11.2017 - 05.2019
- Maintained open and professional team relationships to quickly identify and resolve issues.
- Enforced adherence to company policies, answered coworkers' questions on Help Desk.
- Handled at times stressful Escalation calls.
- Assisted newly hired team members by explaining company procedures and delivered positive feedback upon job task completion.
- Worked unique assigned clients for Outbound calling.
- Monitoring accounts with special strategies due to travel, high dollar purchase memos to identify possible fraud.
Fraud Detection Representative
PSCU
Saint Petersburg, FL
08.2016 - 11.2017
- Review electronic cases produced by the Falcon Fraud Detection System.
- Represent the department professionally in talking to internal and external customers in an inbound/outbound call center.
- Analyze transaction patterns and respond quickly to high-risk situations.
- Identify changing fraud trends, document and report to appropriate department personnel in a timely manner to assist in the reduction of fraud loss.
- Verify account activity and take appropriate action to minimize potential fraud loss and customer inconvenience as well as controlling and managing calls.
- Process Lost/Stolen account calls.
- Maintain daily and monthly performance standards, including those pertaining to quality and quantity.
Office Manager/Chiropractic Assistant
Hess Spinal & Medical Centers
Clearwater, FL
04.2009 - 08.2016
- Manage all daily office operations including answering phones, Cancel and reschedule appointments based upon patient's requests as needed. Insurance verification, medical records requests. Analyzed departmental documents for appropriate distribution and filing.
- Effectively communicate with Insurance agents and attorneys calling in on behalf of the patient.
- Mandatory notetaking of each patient I provided therapy/services for and entering notes with billing codes into the system (Chiro-Touch).
- Coordinating imaging, ortho and specialist referrals.
- Provided manual therapy, Ultrasound therapy, electrical muscle stimulation, and hot/cold packs for patients of the clinic as per the medical director's orders.
- Assisted chiropractors in taking initial intake paperwork including health history and translating from English to Spanish for non-English speaking patients with the patient directly prior to being seen by the doctors.
- Inventory clinical supplies, responsible for ordering all equipment and supplies needed, light cleaning, sanitizing, set in order & maintenance.
- Evaluated patient care needs, prioritized treatment, and maintained patient flow.
Front Office Receptionist/Referral coordinator
Community Health Centers of Pinellas
Clearwater, FL
04.2007 - 04.2009
- Ability to schedule, reschedule, and cancel appointments for patients for a multifaceted medical center with several different departments of physicians.
- Possess ability to verify a wide range of health insurance benefits.
- Possess ability to document notes effectively and in a timely manner.
- Possess ability to be bilingual in reading, writing, and speaking Spanish.
- Effectively communicate with Insurance agents calling in on behalf of the insured.
- Accept co-payments for services as needed.
- Front desk check in/out.
- Obtaining authorizations from insurance companies as needed.
- Light cleaning
Education
High school or equivalent -
Clearwater High School
Clearwater, FL05.2005
Skills
- EMR/EHR management
- Document scanning
- Appointment scheduling
- Payment processing
- Chiro-Touch billing
- Code billing
- Microsoft Office suite
- Eclipse software
- Data analysis
- Quality assurance
- Effective communication
- Team collaboration
- Attention to detail
- Time management
- Administrative support
- Strong communication
- Medical office support
- HIPAA compliance
- Regulatory compliance
- Medical documentation
- Fraud detection systems
- Project management tools
Desired Location
US-FL-Pinellas County/Remote
Languages
- Spanish
- English
Personal Information
Citizenship: U.S.
Timeline
Advanced Medical Support Assistant (Community Care)
Department of Veterans Affairs
06.2024 - 06.2025
National Account Manager
ADT Security
07.2023 - 06.2024
Quality Control Technician
Chromalloy
03.2022 - 07.2023
Payee Provisioning Team Leader
Zelis Healthcare
09.2021 - 03.2022
Payment Operations Specialist
Zelis Payments
08.2020 - 09.2021
Client Service Representative
Zelis Payments
05.2019 - 08.2020
Fraud Detection Lead
PSCU
11.2017 - 05.2019
Fraud Detection Representative
PSCU
08.2016 - 11.2017
Office Manager/Chiropractic Assistant
Hess Spinal & Medical Centers
04.2009 - 08.2016
Front Office Receptionist/Referral coordinator
Community Health Centers of Pinellas
04.2007 - 04.2009
High school or equivalent -
Clearwater High School