Edgar Bolanos
Los Angeles,CA
Summary
Driven professional with a track record of enhancing customer satisfaction at Blue Shield Promise Health Plan. Fluent in English and Spanish, adept in medical terminology, and skilled in navigating CMS, Medi-Cal, and DHCS policies. Demonstrated ability to manage high call volumes and improve our members relations, leveraging clear communication and performance tracking to deliver exceptional service.
Overview
14
14
years of professional experience
Work History
Customer Service Concierge Support, Intermediate
Blue Shield Promise Health Plan
01.2015 - Current
- Enhanced customer satisfaction by promptly addressing inquiries and resolving issues.
- Assist members with complex cases and resolve issues/concerns within a given timeframe.
- Work with doctors, specialists, medical groups to ensure members issues are resolved.
- Experienced in member service policies and procedures as well as HIPAA.
- Responsible for assisting internal departments with any questions regarding member support via email.
- Experienced in working with multiple applications.
- Responsible for supporting our customer service call center to ensure service level is met.
- Responsible for making outbound calls to our new members to welcome them to the plan and answer any benefit questions, as well as ensure members were assigned to the correct provider.
- Also required to be available to assist in any assigned projects and complete them by a given deadline.
- Managed high call volumes while maintaining a professional demeanor, ensuring positive interactions with customers.
Front Office Coordinator
St. John's Well Child And Family Center
03.2010 - 06.2014
- Improved patient relations by proactively addressing concerns or complaints with professionalism and empathy.
- Handled financial transactions responsibly, collecting copayments and processing payments with attention to detail.
- Managed high call volumes effectively, addressing patient inquiries and resolving issues proactively.
- Prepared daily reports for management review, highlighting key performance metrics related to front-office activities.
- Created and updated physical records and digital files to maintain current, accurate, and compliant documentation.
- Offered technical support and troubleshot issues to enhance office productivity.
Education
No Degree - Business Administration
Pasadena City College
Pasadena05.2000
Skills
- Bi-lingual, fluent in English and Spanish
- Knowledge with medical terminology
- Highly trained with CMS, Medi-Cal, and DHCS policies and procedures
- Call center experience
- Clear Communication
- Performance Tracking
Timeline
Customer Service Concierge Support, Intermediate
Blue Shield Promise Health Plan
01.2015 - Current
Front Office Coordinator
St. John's Well Child And Family Center
03.2010 - 06.2014
No Degree - Business Administration
Pasadena City College
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