Diego Meraz
San Antonio
Summary
Detail-oriented professional with extensive experience in health plan support. Skilled in building relationships and managing prior authorizations, ensuring effective communication with members to address inquiries and resolve issues promptly.
Overview
1
1
year of professional experience
Work History
Member Service Representative
Community First Health Plans
San Antonio
11.2024 - Current
- Assist members with PCP changes, demographics, listings, and inquiries about the health plans.
- Assisted members when they had their prescriptions denied, and followed up with the prescriber for prior authorizations and denials.
- Utilized QNXT to process these changes and inquiries for the member.
- Assisted members when they received bills from providers.
- Provided authorization status for members, and followed up with updates.
Education
Diploma -
Douglas Mac Arthur Highschool
San Antonio, TX06-2021
Skills
- Customer service
- Claims processing
- Health plan knowledge
- Prior authorization management
- QNXT utilization
- Relationship building
- Conflict resolution
- Effective communication
- Call center experience
- Adaptability
Languages
Spanish
Native/ Bilingual
Timeline
Member Service Representative
Community First Health Plans
11.2024 - Current
Diploma -
Douglas Mac Arthur Highschool