Elizabeth Contreras
Las Vegas,NV
Summary
Compassionate Healthcare Customer Service Representative known for high productivity and efficient task completion. Skilled in patient communication, data entry accuracy, and healthcare policy understanding. Excel in active listening, empathy, and problem-solving to enhance patient satisfaction and support team objectives.
Overview
4
4
years of post-secondary education
8
8
years of professional experience
Work History
Behavioral Health Advocate
Aetna
Las Vegas, Nevada
08.2025 - Current
- Educated patients and families on mental health resources and outpatient services to ensure seamless access to care
- Provided empathetic support to members within behavioral health systems, handling sensitive inquiries with professionalism and attention to detail.
- Conducted benefits education to clarify complex insurance coverage, copays, deductibles, and eligibility for members, facilitating informed decision-making.
- Maintained accurate documentation while tracking member interactions, claims history, and case notes to ensure compliance and continuity of care. with professional care.
- Maintained strict HIPAA compliance while securely handling sensitive protected health information (PHI) across all channels.
Customer Service Representative
Optum Health United Health Care
Las Vegas, NV
01.2023 - 06.2025
- Answering phones promptly and professionally, providing excellent customer service and addressing inquiries or concerns
- Demonstrating extensive knowledge of HIPAA laws, insurance policies, including coverage details, claim procedures, and eligibility requirements
- Handled pharmacy overrides by reviewing and approving medication requests requiring additional authorization, ensuring patient access to necessary medications
- Conducted claim reversals, ensuring accurate processing of claims
- Handling pharmacy overrides by reviewing and approving medication requests that require additional authorization
- Collaborated with insurance providers, pharmacies, and healthcare professionals to resolve issues and expedite claims, enhancing overall operational efficiency
- Managed high-touch accounts by ensuring personalized service and attention to detail. while following policies and documented in CPD
Customer Service Representative
Optum Health United Health Care
Las Vegas, NV
05.2022 - 01.2023
- Delivered exceptional customer service to members by addressing inquiries and concerns, providing accurate information and assistance to enhance satisfaction
- Guided members in utilizing OTC (Over-the-Counter) credit, explaining eligible items and ensuring a seamless experience throughout the process
- Provided website assistance to members by troubleshooting technical issues and helping them navigate online features for improved user experience
- Designated as a Subject Matter Expert (SME) for the department with in-depth knowledge of products, services, and processes, and served as a resource for colleagues.
- Created training materials aimed at improving call quality, enhancing customer interactions, and ensuring consistent and effective communication
- Facilitated various offline projects to ensure timely completion and effective collaboration., such as handling mail order forms, investigating service tracks and processing orders with holds
HR Coordinator
HMSHost
Las Vegas, NV
08.2021 - 12.2021
- Facilitated the Airport badging process as a certified signatory.
- Supported the HR Manager and HR Generalist in completing assigned tasks.
- Managed New Hire process and conducted background checks on potential associates to ensure compliance and security.
- Processed associate paperwork; W4, direct deposit, and work verifications
- Processed associate paperwork, including W4, direct deposit, and work verifications, to facilitate accurate onboarding.
- Handled all walk in, phone and email inquiries and multi-line telephone system
- Maintained filing system for badged associates
- Supported office operations by handling clerical tasks
- Harry Reid International Airport
AOA Admin/Building Supervisor
YMCA of Southern Nevada
North Las Vegas, NV
01.2021 - 08.2021
- Supported the Active Older Adult Coordinator by managing daily administrative tasks.
- Set up tables and chairs according to rental reservations
- Maintain building and assist any guests inquiring about membership
- Entered programs into Daxko operations to prepare for upcoming events
- Organize and create the monthly AOA Branch Newsletter for all branches in Southern NV
- Arranged tables and chairs based on rental reservations to optimize event setup
- Input programs into Daxko operations for upcoming events
Front Desk Lead
YMCA of Southern Nevada
North Las Vegas, NV
11.2019 - 08.2021
- Managing front desk area, including receptionist function, door security, member access and exit; greets members with a customer friendly attitude.
- Processed enrollments for new memberships and sold programs, contributing to overall membership growth.
- Informing prospects of membership rates and facility amenities
- Processes special programs, camp registrations and guest passes
- Closed out cash drawer at end of each shift, accurately handling cash and inputting payments into daxko to ensure financial accuracy.
- Collaborated effectively with staff to enhance teamwork and communication.
- Executed additional tasks based on operational needs.
Medical Front Desk Lead
Green Valley Fertility Partners
Henderson, NV
03.2018 - 12.2018
- Oversaw front office operations to ensure efficient patient flow and optimal service delivery
- Verifying insurance benefits and obtaining prior-authorization
- Prepared patient charts for doctor consultations to facilitate accurate and timely care
- Collected cash, credit and check transactions for copays and balances.
- New Patient Coordination
- Prepping charts for doctors consultations
- Facilitated the smooth onboarding of new patients by organizing necessary documentation and scheduling.
- Coordinated with coworkers to enhance organization and communication within the work environment
- Assisted in other duties requested by office manager or nurse
Education
High school or equivalent -
Las Vegas High School
Las Vegas, NV 08.2010 - 06.2014
Skills
- Benefits verification
- Claims processing
- Case documentation
- HIPAA regulations
- Benefits education
- Patient advocacy
- Technical troubleshooting
- Critical thinking
- Attention to detail
- Effective communication
- Team collaboration
- Active listening
Personal Information
Willing To Relocate: Anywhere
Timeline
Behavioral Health Advocate
Aetna
08.2025 - Current
Customer Service Representative
Optum Health United Health Care
01.2023 - 06.2025
Customer Service Representative
Optum Health United Health Care
05.2022 - 01.2023
HR Coordinator
HMSHost
08.2021 - 12.2021
AOA Admin/Building Supervisor
YMCA of Southern Nevada
01.2021 - 08.2021
Front Desk Lead
YMCA of Southern Nevada
11.2019 - 08.2021
Medical Front Desk Lead
Green Valley Fertility Partners
03.2018 - 12.2018
High school or equivalent -
Las Vegas High School
08.2010 - 06.2014