Elma Jimenez
Houston,Tx
Summary
Retail and medical experienced individual of 6+ years who is seeking an opportunity with room for growth. High School diploma received and currently obtaining Kinesiology degree. Strong work ethic and great communication with leadership skills. Main goal is to make sure my work is helping the company and patients/customers thrive.
Overview
14
14
years of professional experience
Work History
Service Rep
Salelytics
10.2023 - Current
- Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
- Managed customer inquiries through phone and chat channels daily.
- Resolved customer complaints in a timely manner to ensure customer satisfaction.
- Resolved issues promptly, contributing to improved customer satisfaction.
- Offered resolutions to de-escalate calls and solve customer issues.
- Documented customer interactions in the CRM system accurately.
- Consistently met or exceeded benchmarks for call speed, accuracy, and volume.
- Answered, screened, and processed high volume of calls using call management system and web-based communications.
- Collaborated with team members to improve service delivery processes.
- Trained new staff on call center protocols and best practices.
- Maintained up-to-date knowledge of products and services offered by employer.
PATIENT AFFAIR COORDINATOR II
Houston Methodist Sugar Land Neuroscience and Spine Center
06.2021 - Current
- Demonstrates the skills and competencies necessary to safely perform the assigned job, determined through ongoing skills, competency assessments, and performance evaluations
- Ability to effectively communicate with patients, physicians, family members and co-workers in a manner consistent with a customer service focus and application of positive language principles
- Ability to multitask, prioritize and the flexibility to meet the needs of the department
- Excellent communication and interpersonal skills via telephone and in person
- Demonstrated proficiency in medical terminology to include diagnoses, operative procedures, and CPT codes
- Working knowledge of PC environment utilizing Windows and word processing; basic Excel, Word and PowerPoint knowledge
- Capable of working and navigating several applications and websites related to registration simultaneously
- Managed care knowledge with the ability to differentiate between insurance plans such as PPO, POS, HMO, etc.
- Strong training, coaching to performance and leadership skills
- Reviewed and processed authorization requests for medical services and procedures.
- Communicated with healthcare providers to obtain necessary documentation and information.
- Maintained compliance with insurance guidelines and regulatory requirements during authorizations.
- Utilized electronic health record systems to track and manage authorization statuses effectively.
- Trained new staff on authorization processes, policies, and software tools used in operations.
- Resolved complex authorization issues by liaising between providers and payers to ensure timely patient care.
ADMITTING REP II
Houston Methodist Sugar Land Neuroscience and Spine Center
03.2018 - 06.2021
- Verified insurance information and benefits for seamless patient registration.
- Oversaw patient data entry into electronic health records system, ensuring accuracy for compliance.
- Coordinated with medical staff to ensure timely patient check-in procedures.
- Assisted in scheduling follow-up appointments and diagnostic tests for patients.
- Collaborated with insurance companies to address and resolve verification issues promptly.
- Processed pre-authorization requests for medical services.
- Monitored changes in insurance policies affecting patient care eligibility.
- Trained new staff on insurance verification procedures and systems used.
- Navigated through multiple online systems to obtain documentation.
- Reviewed prior authorization requests for compliance with insurance guidelines.
- Reviewed prior authorization requests to ensure accuracy and completeness of required information.
- Scheduled peer to peer reviews for physicians to discuss medical necessity with insurance providers.
- Contacted insurance carriers to obtain authorizations, notifications and pre-certifications for patients.
- Notified ordering providers of denied authorizations.
Patient Access Service
Houston Methodist Hospital Sugar Land
09.2016 - 04.2018
- Facilitated effective communication between patients and healthcare providers to enhance patient satisfaction.
- Managed patient appointments and coordinated schedules efficiently.
- Processed patient registrations and maintained accurate records consistently.
- Coordinated insurance authorizations, collected co-payments, and resolved discrepancies to streamline patient financial processes.
- Maintained accurate documentation of patient visits and follow-up care plans.
- Trained new staff on office protocols and patient service standards.
- Facilitated patient referrals to appropriate specialty care providers.
Cashier/Business Center/Gas Station
HEB
05.2013 - 04.2017
- Processed customer transactions efficiently and accurately at a busy retail environment.
- Handled cash register operations while ensuring accurate processing of cash and credit transactions.
- Provided excellent customer service at busy gas station locations.
- Operated fuel pumps and ensured proper fueling procedures were followed.
- Assisted customers with product inquiries and provided exceptional service support.
- Addressed customer complaints promptly, contributing to overall satisfaction and retention.
- Trained new cashiers on register operations and customer service protocols effectively.
- Processed payments and managed billing for services rendered to clients.
- Coordinated with team members to manage inventory and restock shelves efficiently.
- Maintained cleanliness of store, fueling areas, and restroom facilities.
Cashier/Floor Sales Associate/Replenishment
Michael’s Arts & Crafts
08.2012 - 03.2016
- Supervised cashier team, improving transaction efficiency and customer satisfaction.
- Trained new staff on cash handling and customer service protocols.
- Managed cash register operations during peak hours, increasing service speed and reducing wait times.
- Resolved customer inquiries and issues with professionalism and care.
- Implemented best practices for maintaining a clean and organized workspace.
- Assisted customers with product inquiries and provided exceptional service.
- Maintained organized and visually appealing merchandise displays on the sales floor.
- Stocked shelves and replenished inventory to ensure product availability for customers.
- Collaborated with team members to optimize store layout, facilitating smoother customer flow and enhancing shopping experience.
- Operated point-of-sale systems accurately during customer transactions and returns.
- Monitored stock levels and reported inventory discrepancies to management promptly.
- Managed inventory levels to ensure timely product availability for customers.
- Assisted in unloading shipments and verifying accuracy of received products.
- Monitored shelf life of products to reduce waste and ensure freshness.
Education
B.S. - Kinesiology
Texas A&M University
College Station, TX02-2028
High School Diploma -
Alief Taylor High School
Houston, TX06.2013
Skills
- Insurance verification
- Utilization review
- Appeals handling
- Authorizations
- Electronic health records
- EHR proficiency
- Patient interaction
- Patient communication
- Customer service
- Customer support
- Complaint handling
- Problem resolution
- Data entry
- Database maintenance
- Schedule management
- Time management
- Compliance adherence
- Remote assistance
- Team collaboration
- Effective communication
- Knowledgeable in epic
- Account management
- Knowledgeable in epic
Languages
English
Professional
Affiliations
Dog foster for Euth listed Animals
Timeline
Service Rep
Salelytics
10.2023 - Current
PATIENT AFFAIR COORDINATOR II
Houston Methodist Sugar Land Neuroscience and Spine Center
06.2021 - Current
ADMITTING REP II
Houston Methodist Sugar Land Neuroscience and Spine Center
03.2018 - 06.2021
Patient Access Service
Houston Methodist Hospital Sugar Land
09.2016 - 04.2018
Cashier/Business Center/Gas Station
HEB
05.2013 - 04.2017
Cashier/Floor Sales Associate/Replenishment
Michael’s Arts & Crafts
08.2012 - 03.2016
B.S. - Kinesiology
Texas A&M University
High School Diploma -
Alief Taylor High School