Neressa Garcia
Hubert,NC
Summary
Detail-oriented and results-driven professional with extensive experience in customer service, healthcare administration, and process improvement. Proven ability to monitor transactions for compliance, provide coaching, and enhance operational efficiencies. Strong leadership, analytical, and mentoring skills with expertise in regulatory compliance, training, and business process optimization.
Overview
6
6
years of professional experience
Work History
Senior Lead LTC Customer Service Transactions Representative, Subject Matter Expert SME
Genworth
03.2022 - Current
- Monitor and evaluate customer service transactions for accuracy and compliance with contracts, servicing standards, and regulatory requirements
- Provide coaching and process improvement recommendations to associates and leadership
- Ensure adherence to operational procedures and offer timely feedback to improve quality outcomes
- Analyze associate performance and recommend training, process enhancements, and policy updates
- Identify business risks and propose mitigation strategies
- Facilitate meetings, provide data-driven feedback, and serve as a peer leader within the Customer Service LTC Team
- Manage critical control reports and contribute to business improvement initiatives
- Utilize systems such as PEGA, CLOAS, and Calypso for claims management and tracking
- Assisted on the phone as needed; mainly mentoring, coaching, and training
- Transactions was my specialty at this job
- Needed to be self-motivated and self-efficient to meet deadlines
Customer Service Representative, SME
Humana Pharmacy
05.2021 - 02.2022
- Assisted customers with pharmacy-related inquiries, including medication refills and OTC orders
- Provided chat-based support and direct communication with team leaders
- Handled supervisor-level calls and system issue resolutions
Customer Service Representative
Conduit
11.2020 - 06.2021
Medical Assistant / Receptionist / Admin Office Manager
Internal Medicine, Timothy M. Gabyrel, M.D. & Associates
09.2019 - 10.2020
Front Desk Associate / Medical Receptionist / Triage
Urgent Care / Primary Care
Amsterdam, NY
01.2019 - 12.2019
- Company Overview: Amsterdam, NY
- Managed a fast-paced clinical environment, prioritizing patient needs and administrative tasks
- Developed strong time-management and multitasking skills critical for efficient healthcare operations
- Amsterdam, NY
Education
Bachelor of Science - Public Health
Southern New Hampshire University
01.2025
Biomedical Sciences
University at Buffalo
06.2020
Skills
- Regulatory Compliance & Quality Assurance
- Customer Service & Client Relations
- Proficient in Microsoft Office Suite software
- Process Improvement & Risk Identification
- Leadership & Team Coaching
- Claims & Insurance Verification
- Medical Reception & Prior Authorizations
- Electronic Medical Records (EMR) Systems (Aledade, Aetna, TheraOffice, eClinicalWorks)
- ICD Coding & Diagnosis
- Data Analysis & Reporting
- Strong Written & Verbal Communication
- Decision-Making & Problem-Solving
- Adaptability & Time Management
- Project Management
- Workday and Talent Management knowledge
- Medical Terminology
Affiliations
Awards
- Teacher Association Recognition Award
- Assembly of English Teachers Award
- Multiple Literacy Awards
- Three-Time Debate Team Winner
- Creativity Award
- Young Leaders of New York State Award
- National Honor Society Member
Languages
Spanish, 2 years through academic institution
Timeline
Senior Lead LTC Customer Service Transactions Representative, Subject Matter Expert SME
Genworth
03.2022 - Current
Customer Service Representative, SME
Humana Pharmacy
05.2021 - 02.2022
Customer Service Representative
Conduit
11.2020 - 06.2021
Medical Assistant / Receptionist / Admin Office Manager
Internal Medicine, Timothy M. Gabyrel, M.D. & Associates
09.2019 - 10.2020
Front Desk Associate / Medical Receptionist / Triage
Urgent Care / Primary Care
01.2019 - 12.2019
Bachelor of Science - Public Health
Southern New Hampshire University
Biomedical Sciences
University at Buffalo
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