Open To Work
Desiree Rangel
Lakewood,CO
Summary
Detail-oriented Claims & Customer Resolution Specialist experienced in managing complex insurance-related inquiries and resolving high-volume cases. Delivered exceptional customer service through effective problem-solving, multitasking, and research skills. Targeting transition into Claims Adjuster role to leverage investigative and compliance expertise for enhanced customer advocacy.
Overview
6
6
years of professional experience
1
1
Certification
Work History
Customer Care Representative III
Elevance Health / Ameriben (Anthem)
Denver, CO
06.2021 - Current
- Handled complex member inquiries regarding claims, benefits, eligibility, and provider contracts, ensuring accurate information delivery.
- Investigated and resolved escalated issues while ensuring compliance, improving overall issue resolution effectiveness.
- Reviewed documentation to determine resolutions aligned with policy guidelines, enhancing member satisfaction.
- Document all interactions and outcomes accurately in multiple systems.
Customer Service Representative
Maximus
Las Vegas, NV
04.2021 - 06.2021
- Delivered exceptional customer support via phone and online channels.
- Handled high-volume inbound calls, verified sensitive information, and provided health-related guidance, ensuring confidentiality and client trust.
- Resolved customer inquiries with empathy and active listening skills.
- Built rapport with clients and delivered accurate information under pressure, enhancing customer satisfaction.
- Collaborated with team members to improve service processes and procedures.
Customer Service Representative
Hire Connections
Centennial, CO
10.2020 - 04.2021
- Assisted customers with inquiries regarding health insurance plans and benefits.
- Guided clients through the claims process to ensure timely resolution.
- Collaborated with team members to address customer service challenges effectively.
- Collected and processed sensitive health data while coordinating scheduling for large-scale vaccination events to ensure accuracy and compliance with health guidelines.
Education
Arts (Associate) -
Skills
- Inquiry resolution
- Customer Service
- First call resolution
- Call handling efficiency
- Customer Resolution
- Conflict resolution
- Problem resolution
- Rapport building Solving
- Time Management
- Sales Support
- Front Desk
- Data Entry
- Microsoft Office
- Microsoft Excel
- Microsoft Word
- Microsoft Powerpoint
- Microsoft Outlook
- Windows
- Computer Operation
- Computer skills
- Admin expertise
- Health insurance knowledge
- HIPAA
- Policy Interpretation
- Call center
- Documentation accuracy
- Compliance adherence
- Effective communication
- Active listening
- Team collaboration
- Effective communication
- Writing skills
- Assistant Manager Experience
- Team collaboration
- Rapport building
- Customer service
- First call resolution
- Problem resolution
- Documentation accuracy
- Compliance adherence
Certification
- Cosmetology License, 05/01/24, 04/30/26
- Driver's License, 10/01/20, 02/28/26
Additional Information
Authorized to work in the US for any employer, Information Technology, CIS 106 - Introduction to Information, CIS 109 - Introduction to Management, CIS 110 - Computer Programming Design
Work Preference
Job Search Status
Open to workWork Type
Full TimeLocation Preference
RemoteSalary Range
$52000/yr - $200000/yrTimeline
Customer Care Representative III - Elevance Health / Ameriben (Anthem)
06.2021 - Current
Customer Service Representative - Maximus
04.2021 - 06.2021
Customer Service Representative - Hire Connections
10.2020 - 04.2021
Strayer University - Arts (Associate),