Dariela E. Rabago

• When necessary, assist with Supervisor Escalated calls from members or providers to ensure resolution to complaints and/or issues
• Monitored and updated claims status in claims processing system.
• Managed large volume of medical claims on daily basis.
• Followed up on denied claims to verify timely patient payment and resolution.
• Researched and resolved complex medical claims issues to support timely processing for claims of 100K+
• Identified and resolved discrepancies between patient information and claims data.
• Paid or denied medical claims based upon established claims processing criteria.
• Assessed medical claims for compliance with regulations and corrected discrepancies.
• Reviewed provider coding information to report services and verify correctness.
• Checked documentation for accuracy and validity on updated systems.
• Carried out administrative tasks by communicating with clients, distributing mail, and scanning documents.
• Assured timely verification of insurance benefits prior to patient procedures or appointments.
• Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
• Posted payments to accounts and maintained records.

Prepared insurance claim forms or related documents and reviewed for completeness.

• Supervised the office when Apartment Manager was unavailable or otherwise engaged
• Managed property financial records by collecting rent from 65 tenants and reconciling monthly accounts payable and receivable.
• Conducted move-out and move-in inspections to determine charges for damages and market readiness.
• Implemented and enforced policies and procedures to maintain properties to highest standards.
• Monitored and tracked payments and expenses, providing timely and accurate financial reports.
• Duties included supervising leasing agents during the day, bookkeeping, payroll, timesheets, and collecting on past due accounts

• Process check orders using windows programs and internal programming for the production and design of bank stock checks with heavy internet usage and problem solving skills to locate information which was missing from check orders received
• Gained customer trust by providing knowledgeable and accurate information in both English and Spanish.
• Assisted customers with Spanish-language inquiries in a timely and professional manner.
• Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
• Met all call quality standards and daily quotas for first-call resolution.
• Developed a deep understanding of customer service principles and customer service best practices.
• Investigated and resolved customer inquiries and complaints quickly.
• Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
• Met customer call guidelines for service levels, handle time and productivity.
• Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
• In charge of managing 10-15 associates when supervisor was not on the floor or was absent, and was responsible for distributing work to all associates appropriately from the queue’s needing to be cleared
• Towards the end of my employment, I was solely responsible for all of our brokerage account checks and items ordered, and was required to attend to their every need as they were VIP clientele.