Cynthia Salinas

Customer Service/Call Center/Email

• Took phone calls, confirmed benefits, reviewed claims. reconciled claims and payments.
• Assisted with making doctor appointments, called providers regarding invoices and claims.
• Educated members on available wellness services and guided each through process.
• Educated members on their insurance plan, how it works, meaning of deductibles, co-insurance and best practices.

Client Advocate

• Manage my assigned book of business, currently 10 clients (employers) with over 2,500 lives.
• Work directly with our clients Human Resource departments to ensure their benefits are administered correctly.
• Work in resolving any escalated claim or payment concern, reconcile payments, send missed claims for processing, any claims that need adjusting or correcting I will send for correction.
• I complete account audits as well as payment audits.
• I call our members and assist with understanding their health benefits, how to file claims, how to use their international and US insurance, obtain guarantee of payment, assist with what is needed to have our medical team review and approve procedures/medication.
• Each issue that I take on I own from start to finish, ensuring claims are processed, adjusted correctly and I close loops with client or member on each issue.
• I create certificate of coverages required for Visa applications.
• I schedule weekly, monthly or bi-monthly calls with our clients to review escalated claim concerns. account trends or issues. Lead new enrollment meetings on how to use their insurance and member website, lead meetings in Spanish.
• I translate documents for team members as needed.
• I provide assistance with authorization overrides.
• Participate in meetings with Client Manager, Clients, Eligibility, and Legal Team to discuss account objectives and strategies.
• Cultivate and maintained relationships with internal colleagues and departments.
• Educate members on available wellness programs and guided each through processes needed
• I assist members with pre-departure requirements and procedures in relation to medication and health care.
• Provide assistance with insurance referrals, medical review requests and authorization overrides.
• Track issues to ensure there are no negative trends, if there is work with internal partners or client as needed to find resolution.
• Monitored progress towards service plan goals.
• Review client reports, these are weekly, bi-weekly or monthly depending on client. I review denied claims, claims that are over our processing times and escalate for completion as needed.
• Travel for client meetings and renewals as needed, to include outside of the country.

• First task completed was to work with the IRS on becoming exempt non-profit organization. LHS Athletic Boosters was assigned and EIN but it was not recognized as exempt from tax filing or non-profit.
• Worked quickly on fundraising to get our program out of deficit
• Brought on capable and hard working board members which maximized our productivity, sponsors, donations and volunteers.
• Cultivated strong relationships with external businesses, community members, coaches to obtain sponsors.
• Created succession plans to provide continuity of this organization during leadership transitions.
• Revamped our Golf Tournament which is our largest fundraising event.
• Create, order and sell gear as part of our fundraising.
• Volunteer along side parents to encourage volunteering and parent involvement with our organization and with LHS.
• Work closely with coaches and understand their athletic programs needs and best financial way our program can assist.
• Work closely with Learner-Athletes and be attuned to their needs. One big thing we pride ourselves in is ensuring each athlete has opportunity to play a sport. We provide and pay for basic needs for athletes if needed, this is anywhere from shoes, basic needs for our women athletes, food vouchers and at times driving them to obtain physical. Anything LHS does not provide, we will.
• When working with Learner-Athletes so closely you become aware of their home situation and other needs. I have had to refer many learners to counseling, your office, attended meetings with LHS Admin as requested by learners.
• I have done two fundraisers for learners on a personal basis when their parents passed away, all stemming from volunteering and helping learner-athletes.
• Worked closely with LHS to encourage parent involvement to include presentations at back to school night, having informational booth, to include Cardinal Gear merchandise sales.

• Collaborated with parents to reach fundraising potential.
• Worked with learners to help understand and overcome personal, social or behavioral problems affecting educational or vocational situations.
• Empowered students through counseling and skill-building exercises.
• Delivered supportive and knowledgeable counseling to students with personal concerns.
• Completed all paperwork, required for ASB to include fundraising requests, spending requests, completed fundraisers & maintained financial records.
• Encouraged parents to donate, volunteer and work along side of their learners to reach full potential of our Class.

• Answered multi-line phone system and enthusiastically greeted callers.
• Check signatures and legal descriptions for accuracy.
• Explained very technical financial information to applicants in easy to understand language.
• Scheduled closing appointments for seller and buyer or arranged for delivery of documents for out of area closings.
• Developed and maintained relationships with customers, lenders and other third parties.
• Responded to emails and other correspondence to facilitate communication and enhance business processes.
• Provided clerical support to company employees by copying, faxing, and filing documents.
• Entered data into system and updated customer contacts with information to keep records current.

• Assessed clients' needs and determined eligibility for intake services.
• Completed intake assessment forms and filed clients' charts.
• Explained eligibility requirements, application details, benefits payment methods, and applicants' legal rights during intake assessment.
• Answered phone calls and provided new clients with required paperwork to initiate service.
• Provide referral's and recommendations for further community assistance.
• Maintained ongoing eligibility for benefits
• Schedule and complete annual benefit review
• Process benefit overpayments
• I maintained case load of 250-300 families.
• Maintained accurate and up-to-date client records.