Desiree Mercado
Bakersfield,US
Summary
Dedicated and experienced professional with a proven track record in healthcare and community engagement. Seeking a challenging position in a customer-focused role where I can leverage my expertise in answering questions, resolving issues, and delivering outstanding support to ensure customer satisfaction.
Overview
10
10
years of professional experience
Work History
ARC REpresentative
Magnit Solutions- CIGNA Healthcare
07.2023 - Current
- Product information about medicare supplement
- Application support
- Request for information questions and completion
- Callouts for New Business
- Guaranteed issue questions
- New Business procedures
- CignaforBrokers and ExpressApp questions and issues
- Commissions questions
- Agent welcome calls
- Dedicated ARC spanish queue
- Walk agents through creating a new medicare supplement application, servicing that application and provide policy status
- Help agents understand the "why?" when a RFI requires a correction, help understand to avoid further mistakes. if there is a guaranteed issue concern, we advise on rules federal and state specific and cigna specific
- We also advise on procedure questions such as turnaround time, what needs to be completed to process such as PV, UW , and licensing issues. and if there are any specific barriers based on how we process applications.
- In special cases ARC rep may call out to an agent or applicant for missing or confusing information at the request of New Business.
- ARC rep helps with basic assistance with contracting issues such as: verifying agent company and state status (active, pending, terminated) and verifying hierarchy
- Cigna for brokers assistance looking for servicing forms.
- General questions before transferring to contracting department.
- Cigna for brokers assistance creating account.
- Login and MFA assistance
- Showing agents how to look up customer information, policy details, status and upload documents.
- Teaching agents how to check correspondence statements and run commission reports.
- Downloading forms and materials and ordering supplies.
- Accessing servicing forms for agent contracting and customer service issues.
- Checking out ongoing incentives on our wincentives page.
- Finding copies of ExpressApp application
- Accessing and using ExpressApp
- Troubleshooting login and site errors and making/following up on tickets when needed.
- ExpressApp assistance, selecting the correct campaign.
- Generating a quote for a product
- Making policy selections and understanding what is and isn't available in a location for a demographic.
- Completing and resuming applications
- Troubleshooting login and state errors and making/following up on tickets when needed.
Fact Finding agent for EDD- Remote
Aston Carter- Maximus
05.2022 - 01.2023
- Analyzing claim information to determine the cause of outstanding issues
- Assessing eligibility requirements based on UI Code, Policies, and Procedures
- Evaluating wage and earnings
- Communicating with claimants and employers by phone to obtain missing information
- Working closely with subject matter experts
- Referring more complex issues to supervisor or tenured staff
- Notating all contacts and actions taken on a claim
- Demonstrating the ability to make timeline and logical decisions
- All other duties as assigned by management to support claim processing
- Comply with and adhere to all policies and procedures including HIPAA and PCI compliance requirements
- Worked with multiple systems including Nice, Virtual Contact System, SCDB/OTECH, CUBS, Microsoft Teams, Amazon Workstation, Zoom, Salesforce, Cornerstone Learning, and Virtual desktops
- Participated in over 150 hours of professional development courses.
Case Manager
Bakersfield Homeless Center
11.2020 - 05.2022
- Identify and assist clients in securing housing, basic needs, medical, and mental health services
- Provide strengths-based case management and service coordination
- Maintain accurate and timely records of activities
- Develop and maintain relationships with clients, staff, and local service providers
- Act as a liaison between other community service organizations
- Handle referrals to community service providers
- Assist and cooperate with other case managers
- Follow detailed accounting procedures for check requests for financial assistance
- Complete comprehensive written evaluations of client life situations, problems, needs
- Assist clients with housing retention and money management functions
- Advocate for clients with landlords
- Conduct housing inspections
- Identify and assist clients in securing housing, basic needs, medical, and mental health services.
Receptionist
Clinica Sierra Vista - Ebony Counseling Center
10.2018 - 10.2020
- Provided administrative support to staff members and clients
- Scheduled and confirmed assessments and counseling appointments
- Distributed incoming mail
- Acted as the first point of contact for potential clients
- Greeted clients/visitors and provided information
- Directed clients to the appropriate staff
- Updated and maintained rehab flyers
- Helped ensure a safe, clean working environment
- Scheduled clients for their intramuscular shots
- Verified Medi-Cal insurance
- Screened all clients and staff prior to entering the office due to covid-19.
Medical Records Clerk/Receptionist
Clinica Sierra Vista - South Central Children's Behavioral Health Center
11.2013 - 10.2018
- Maintained client confidentiality
- Ensured HIPAA compliant release of information
- Maintained medical records information
- Filed complete medical records
- Retrieved medical records for clinicians
- Released information to persons and agencies
- Assembled new charts
- Verified completeness and correctness of medical records
- Assisted in translating
- Reviewed charts and flagged incomplete or inaccurate information
- Assisted in administrative duties in the front desk.
Education
Business Administration - Associate of Science -
SJVC Bakersfield
Bakersfield, CA01.2013
High School -
West High School
Bakersfield, CA01.2011
Skills
- Seven years of experience working in mental and substance abuse clinics, providing compassionate care and support to clients
- Two years of experience as a case manager, assisting the homeless community and addressing their unique needs
- Proficient in maintaining confidentiality and adhering to privacy laws, including a strong understanding of HIPAA regulations
- Demonstrated ability to resolve issues effectively, resulting in increased customer satisfaction
- Fluent in English and Spanish, enabling effective communication with diverse populations
- Highly organized with excellent record-keeping, file management, and auditing skills
- Skilled in Microsoft Office Suite, including MS Outlook, ensuring efficient administrative support
- Strong telephone etiquette and customer service skills, dedicated to providing a client-focused experience
- Adaptable and capable of working independently, as well as collaboratively in a team environment
- Technical Troubleshooting
- Customer Support
- Client Services
Languages
Spanish
Full Professional
Timeline
ARC REpresentative
Magnit Solutions- CIGNA Healthcare
07.2023 - Current
Fact Finding agent for EDD- Remote
Aston Carter- Maximus
05.2022 - 01.2023
Case Manager
Bakersfield Homeless Center
11.2020 - 05.2022
Receptionist
Clinica Sierra Vista - Ebony Counseling Center
10.2018 - 10.2020
Medical Records Clerk/Receptionist
Clinica Sierra Vista - South Central Children's Behavioral Health Center
11.2013 - 10.2018
Business Administration - Associate of Science -
SJVC Bakersfield
High School -
West High School
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