DANIELLE GUERRERO
Hope Mills,NC
Summary
Dedicated team player adept at managing customer service and claims processing for policyholders. Looking for a long-term position with a growth-oriented company.
Experienced in processing claims in high-volume environments. Successful at managing complete claims process with minimal direction. .
Passionate and professional Representative leads outreach efforts, strategic direction and day-to-day function management. Proven talent at building relationships and influencing others to gain support and commitment. Excellent presentation and communication skills and comfort working in fast-paced environment.
Experienced in claims processing with solid understanding of insurance procedures and regulations. Strengths include adept problem-solving skills, high level accuracy and comprehensive knowledge of claims management systems. Noted for consistently improving efficiency and reducing errors in previous roles.
Overview
11
11
years of professional experience
Work History
Advocate4me Rep Sr.
United healthcare
Greensboro, North Carolina
10.2023 - Current
- Provided customer service by answering product and service related questions.
- Resolved customer complaints in a professional manner while remaining empathetic to their concerns.
- Escalated unresolved issues to appropriate departments for further investigation.
- Resolved customer complaints regarding claim processing delays or denials.
- Analyzed complex data sets associated with each claim to identify discrepancies or fraud indicators.
- Provided feedback to customers on their claim progress.
- Prepared adjustment documents for processing of payments or denials of claims.
- Documented detailed notes about every step taken while investigating a claim.
Medical Assistant
WellMed Medical Management - United Health Group
El Paso, TX
03.2023 - 10.2023
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Educated patients about medications, procedures and physician's instructions.
- Organized charts, documents and supplies to maintain team productivity.
- Secured patient information and maintained patient confidence by completing and safeguarding medical records.
- Assisted with diagnostic testing by collecting and packaging biological specimens for internal and laboratory analysis.
- Participated in team meetings to improve workflows and contribute to improving patient population outcomes.
- Performed preliminary physical tests to accurately record results in patient history summary.
- Documented notes during patient visits.
Medical Assistant
New Light Primary Care
El Paso, TX
02.2021 - 03.2023
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Scheduled appointments for patients via phone and in person.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Educated patients about medications, procedures and physician's instructions.
- Contacted pharmacies to submit and refill patients' prescriptions.
- Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.
- Batch-scanned and indexed patient charts to improve data availability while maintaining security.
- Completing orders labs, dm eye, dm foot, mammogram, bone density etc
- Performed EKG, ABI/ ANS, Balance Test
Medical Assistant ( Military Move)
Stopwatch Urgent Care
Phenix City, AL
09.2020 - 01.2021
- Conducted patient interviews to gather health history, vital signs and information about current medical issues.
- Prepared, reviewed and submitted patient statements to determine factual accuracy.
- Assisted physicians by preparing patients for procedures, including EKGs, phlebotomy, glucose testing and pulmonary function tests.
- Communicated with patients by phone and via written correspondence.
- Monitored medical supply levels to confirm sufficient stock, promptly placing replenishment orders before depletion.
- Secured patient information and maintained patient confidence by completing and safeguarding medical records.
- Processed and produced ER, OR and portable x-ray information to assist diagnosis.
- Collaborated with radiologists, sonographers and other healthcare team members to streamline patient care.
- Assisted patients in preparation for examinations, assessing and recording vital signs.
- Assessed, documented and monitored vital signs for more than 100 patients per day.
- Maintained inventory, vaccination and product expiration logs to record updated documentation for tracking purposes.
- Sterilized medical instruments to streamline procedural use.
- Maintained clean and organized work area with adequate supplies and reagents.
- Followed strict aseptic techniques to protect patients when collecting blood and tissue samples.
- Administered medications based on clinical condition and patient age.
- Viewed electronic health system records to evaluate patient wound care history, other relevant medical information and prescription medications.
- Conducted wound assessments for patients and documented information.
- Worked with healthcare teams to assess patients, manage wounds and monitor healing.
- Coordinated care with charge nurse and other staff through daily communication.
Front Desk
Sunshine Fitness
Phenix City, AL
02.2018 - 09.2020
- Tracked warehouse contents continually, constant awareness of stock levels and performed formal inventory review.
- Demonstrated full store expertise on merchandise locations, enabling optimum service to inquiring customers.
- Trained internal staff members on administrative processes, work instructions and procedures to facilitate consistent and seamless company operations.
- Solved minor customer issues and escalated major problems immediately to Manager.
- Coordinated front desk operations and diligently helped all in-person visitors and callers with knowledgeable assistance.
- Maintained accurate bookkeeping of important files, ran reports and delivered updates on occupancy and revenues to club manager on daily basis.
- Signed for packages, recorded all deliveries and distributed to inter-company personnel.
- Monitored safety, health and sanitation processes throughout all areas and enforced rules to promote security and safety.
- Managed customer complaints and rectified issues to complete satisfaction.
Customer Service Representative (Military Move)
AT&T
Pueblo, CO
11.2015 - 06.2017
- Confer with customers by telephone or in person to provide information about products or services, take or enter orders, cancel accounts, or obtain details of complaints.
- Check to ensure that appropriate changes were made to resolve customers' problems.
- Keep records of customer interactions or transactions, recording details of inquiries, complaints, or comments, as well as actions taken.
- Determine charges for services requested, collect deposits or payments, or arrange for billing.
- Refer unresolved customer grievances to designated departments for further investigation.
- Review insurance policy terms to determine whether a particular loss is covered by insurance.
Caregiver
Premium Direct Care
Pueblo , Co
04.2014 - 12.2016
- Administer bedside or personal care, such as ambulation or personal hygiene assistance.
- Prepare and maintain records of client progress and services performed, reporting changes in client condition to manager or supervisor.
- Perform housekeeping duties, such as cooking, cleaning, washing clothes or dishes, or running errands.
- Care for individuals or families during periods of incapacitation, family disruption, or convalescence, providing companionship, personal care, or help in adjusting to new lifestyles.
- Perform healthcare-related tasks, such as monitoring vital signs and medication, under the direction of registered nurses or physiotherapists.
- Plan, shop for, or prepare nutritious meals or assist families in planning, shopping for, or preparing nutritious meals.
- Transport clients to locations outside the home, such as to physicians' offices or on outings, using a motor vehicle.
- Participate in case reviews, consulting with the team caring for the client, to evaluate the client's needs and plan for continuing services.
- Provide clients with communication assistance, typing their correspondence or obtaining information for them.
- Administer bedside or personal care, such as ambulation or personal hygiene assistance.
- Prepare and maintain records of client progress and services performed, reporting changes in client condition to manager or supervisor.
Education
NHA Certification - Clinical Medical Assistant
First Step Health Agency
Columbus, Ga07.2020
High School Diploma -
Centennial high school
2008
Pharmacy Technician - Pharmaceutical Sciences
Med Certs
Michigan, ND12.2019
Certication -
BLS/CPR Ceritified
American Red Heart Association 07.2020
Skills
- Wound care and irrigation
- HIPAA compliance
- Advanced anatomy knowledge
- Understands medical procedures
- Professional bedside manner
- Proper sterilization techniques
- Venipuncture and phlebotomy
- Patient skin and nail care
- Medical terminology
- Specimens collection and processing
- Certified in Basic Life Support (BLS)
- Vital sign monitors
- Electrocardiography (EKG)
- Policy Interpretation
- Claims Handling
- Claims investigations
- Teamwork and Collaboration
- Insurance Claim Forms Review
- Claims processing software
- Multitasking capacity
- Claims investigation
Personal Information
- In addition, A quick learner that's alway willing to learn new things and always ready to work. I am also a very self motivated person that once I put my mind on it will do what it takes to complete.
Timeline
Advocate4me Rep Sr.
United healthcare
10.2023 - Current
Medical Assistant
WellMed Medical Management - United Health Group
03.2023 - 10.2023
Medical Assistant
New Light Primary Care
02.2021 - 03.2023
Medical Assistant ( Military Move)
Stopwatch Urgent Care
09.2020 - 01.2021
Front Desk
Sunshine Fitness
02.2018 - 09.2020
Customer Service Representative (Military Move)
AT&T
11.2015 - 06.2017
Caregiver
Premium Direct Care
04.2014 - 12.2016
NHA Certification - Clinical Medical Assistant
First Step Health Agency
High School Diploma -
Centennial high school
Pharmacy Technician - Pharmaceutical Sciences
Med Certs
Certication -
BLS/CPR Ceritified