Diana Rebolledo
San Benito,TX
Summary
Highly organized Client Service Representative possesses strong communication, problem-solving, and multitasking skills. Skilled in building strong relationships with clients and providing quality service. Hardworking and passionate job seeker with strong organizational skills eager to secure a promotion. Ready to help achieve company goals.
Overview
7
7
years of professional experience
1
1
Certification
Work History
Member Services Representative
UnitedHealthcare
11.2021 - Current
- Helped a large volume of members with positive attitude and focused on customer satisfaction by: assisting retirees with plan concerns; Medical claims, Prescription claims, Benefit coverage, provider network, pharmacy network, Prior Authorizations, Appeals, Grievances. Handle customer complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution.
- Utilize active listening skill to identify members needs and provide appropriate solutions.
- Follow communication procedures, guidelines and policies.
- Provide support to immediate supervisor with birthday and anniversary notices, sent out daily adherence reports, sent out 2 in 48 reports, kept a live tracker of 2 in 48 progress, assisted with UES call reviews, provided coaching session for those who needed additional guidance, assisted program software access/issues,
- Cross Trained and provided backup support for leadership
- Team trailblazer - assist with escalated calls
- Compliance Champion - appeals, Grievances and prior Authorizations
- Assisted with quarterly test calls
Leas Case Aide, Lead File Clerk, Lead Reunification Flight Clerk
Sunny Glen Children's Home New Day Resiliency Center
10.2019 - Current
- Examined, categorized, and sorted incoming documents.
- Assisted with data entry and administrative support tasks to help meet team goals.
- Sorted and classified documents into appropriate filing systems for increased traceability.
- Maintained physical and computer-based filing systems.
- Daily, Weekly and Monthly audits to ensure all case file remained compliant.
- Worked closely with travel agencies to ensured flights were secured, scheduled, documented and finalized.
- Managed sensitive or confidential files with attention to data security and storage policies.
- Created Workflows, Policies, Manuals, Employee Schedules,
- Hosted weekly meetings
- Accomplished department objectives by supervising staff and monitoring work processes.
- Maintains staff by recruiting, selecting, orienting, and training employees
- Accomplished staff job results by coaching, counseling, and disciplining employees.
Social Services Administrative Assistant
Sunny Glen Children's Home
06.2017 - 10.2019
- Conducted ongoing audits on education and medical case files
- Worked close with DFPS licensing representatives on a daily basis, Surrounding School, Medical Clinics, Medical Professionals, and Foster Parents
- Responsible for supply inventory
- Assisted with Bank Account Balances, Reconciled DFPS Statements,
- City, County and State Audits
- Assisted Direct Care staff when coverage was needed
- Collaborated with CEO to modify an electronic health filing system (kaleidacare)
- Converted all active physical case files to electronic platforms.
Direct Care Staff
Sunny Glen Children's Home
04.2016 - 06.2017
- Ensure child safety and well being
- Facilitated psycho education sessions
- Transport to medical, dental, vision, Medical office visits and school if needed
- Focused and educated all youth on sanctuary
- Mentors, enforce rules and model positive behaviors.
- Organize and facilitate recreational activities including games, physical fitness events, arts and crafts
- Maintain a safe and healthy environment
- Administered Medications as directed by physician.
- Make positive changes in childs life and handle high-stress situations.
Education
criminal justice
Salon And Spa Institude
Brownsville, TX04.2009
High School Diploma - Criminal Justice
University of Texas In Brownsville
Brownsville, TX2008
Los Fresnos High School
Los Fresnos, TX05.2006
Skills
- Bilingual in Spanish and English
- Excellent communications skills
- Problem solving
- Fast Learner
- Organization
- Multi phone etiquette
- Attention to detail
- Proficient with Microsoft Word, Excel, Powerpoint, Outlook
- Decision making
- Time Management
- Computer skills
- Flexible and Adaptable
Certification
CPI Certified
January 2016 to January 2019
CPR Certified
January 2017 to October 2021
Handle With Care
October 2018 to October 2021
First Aid Certification
Additional Information
- Authorized to work in the US for any employer
Timeline
Member Services Representative
UnitedHealthcare
11.2021 - Current
Leas Case Aide, Lead File Clerk, Lead Reunification Flight Clerk
Sunny Glen Children's Home New Day Resiliency Center
10.2019 - Current
Social Services Administrative Assistant
Sunny Glen Children's Home
06.2017 - 10.2019
Direct Care Staff
Sunny Glen Children's Home
04.2016 - 06.2017
criminal justice
Salon And Spa Institude
High School Diploma - Criminal Justice
University of Texas In Brownsville
Los Fresnos High School