Elizabeth Vazquez
Santa Ana,CA
Summary
15+ years of customer service and 10+ years of dental background. A personable and dedicated, solid team player with an upbeat., positive attitude. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality speed and process optimization.
Overview
20
20
years of professional experience
Work History
Payor Relations
Western Dental Corp.
03.2022 - 07.2024
- Receives and responds to all complaints and grievances from health plans or regulatory agencies
- Collects all necessary documentation required to respond to complaints and grievances
- Maintains complete, accurate, and up to date records and tracking logs of all activities related to grievances
- Advises health plans, members, providers and management of progress made towards resolution of member complaints, grievances, and claims appeals and advises of any problems encountered
Member Services(Administration)
California Dental Network
10.2017 - 11.2021
- Provide Customer Service by answering incoming calls (multi-line phone system) from customers and providers requesting information and resolving clients inquiries
- Post payments (checks and credit card)
- Processing Referrals in a timely manner/ process emergency referrals
- Log all inquiries into to the system and assign follow ups in the system as needed
- Perform request a dentist functions to locate a provider and complete the placement of the member
- Adding new members information to data base
- Processing payments and refunds
- Gathering policy information for our members
- Contributed to a positive work environment by maintaining a clean and organized workspace at all times.
Technical Advisor
Glidewell Dental Laboratory
04.2016 - 05.2017
- Communicated with customers, colleagues, dental technicians and managers in a prompt articulate manner
- Provided administrative support such as answering inbound telephone calls, checking on ship dates, offering information on all products, updating new account information and inputting call notes in GCM
- Evaluated each case thoroughly and advised doctors on which product is the best for the particular case
- Coordinated and performed a range of department support activities; served as a liaison between other divisions/departments and ensured customer retention and satisfaction
- Familiar with internal as well as external digital work flows
Insurance Tracer
SmileBrands
05.2015 - 03.2016
- Updated all patient accounts to correct inaccurate information (Eligibility dates, termination date and contract allowable and or maximum)
- Called Insurance Carriers and verified if claims were received and the outcome status
- Worked zero and partial paid Explanation of Benefits (EOB) and took action to appeal claims
- Ensured claim submission for secondary coverage within timely filing limits
- Ensured response to claim inquiry and tracing within timely filing limits
- Conducted full patient account audits on QSI to determine appropriate action
Customer Service Representative
Plaza Mufflers Inc.
08.2011 - 10.2014
- Call center representative- Inbound/outbound
- Maintained established record and files
- Assisted with collections calls
Member Services
SmileCare Dentistry Corp.
09.2004 - 09.2010
- Offered the in house insurance to patients that had no type of coverage
- Assisted customers and offices with any questions and need regarding the company
- Responsible for weekly and monthly reports regarding payments and delinquency
- Responsible for receptionist duties as far as answering phones and incoming/outgoing mail
- Managed inbound/ outbound calls of patients complaining about unsatisfactory treatments
- Responsible for keeping record and subpoenas; uploaded and retrieved patient documents
- Assisted customers and suppliers with any questions and need regarding the company
- Clinical reviews with the chief director(doctor) Scanning department
- Checked, analyzed and classified materials; conducted limited research when necessary
- Scanned information from source document, codes numerically, and created templates in the same index records and information
- Checked to ensure that dental records contain the correct information for retrieval by billing
- Maintained established records and files
Education
Diploma -
Saddleback High School
Santa Ana, CA06.2001
Skills
- Teamwork capabilities
- Leadership Qualities
- Insurance Verification
- 10 Key Data Entry
- Multi-line phone systems
- Microsoft Excel/Word
- Grievance handling
- Teamwork and Collaboration
- Customer service
- Bilingual English/Spanish
- Administrative experience
- Problem-Solving
Timeline
Payor Relations
Western Dental Corp.
03.2022 - 07.2024
Member Services(Administration)
California Dental Network
10.2017 - 11.2021
Technical Advisor
Glidewell Dental Laboratory
04.2016 - 05.2017
Insurance Tracer
SmileBrands
05.2015 - 03.2016
Customer Service Representative
Plaza Mufflers Inc.
08.2011 - 10.2014
Member Services
SmileCare Dentistry Corp.
09.2004 - 09.2010
Diploma -
Saddleback High School
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