Elvia Herrera
Moreno Valley,CA
Summary
Dynamic professional with a robust background in customer interactions and service solutions, dedicated to fostering exceptional customer experiences. Expertise in conflict resolution, communication, and problem-solving drives consistent customer satisfaction and loyalty. Proven team collaborator, adaptable to evolving needs while maintaining a steadfast focus on achieving results through efficient and empathetic service. Recognized for reliability and a proactive approach to fulfilling both customer and organizational objectives.
Overview
6
6
years of professional experience
Work History
Customer Service Representative Sr
United Healthcare
10.2023 - 06.2025
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Participated in cross-functional teams to discuss ways to improve overall customer satisfaction across company.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
Patient Engagement Representative
Riverside Medical Clinic
05.2021 - 09.2023
- Implemented innovative outreach programs aimed at educating underrepresented communities about available healthcare resources.
- Contributed to the creation of marketing materials that highlighted the benefits of patient engagement services, attracting new clients to the practice.
- Enhanced patient engagement by developing and implementing personalized care plans.
- Developed assessment tools to evaluate the effectiveness of implemented engagement tactics, leading to continuous improvement efforts within the program.
- Answered incoming calls, scheduled appointments and filed medical records.
Insurance Verifications Specialist
UMIH Downey
10.2019 - 02.2021
- Ensured compliance with HIPAA regulations while managing sensitive patient information during the verification process.
- Assured timely verification of insurance benefits prior to patient procedures or appointments.
- Updated patient records with accurate, current insurance policy information.
- Made contact with insurance carriers to discuss policies and individual patient benefits.
- Complied with HIPAA guidelines and regulations for confidential patient data.
- Maintained strong knowledge of basic medical terminology to better understand services and procedures.
- Improved communication between medical staff and patients by explaining insurance benefits and financial responsibilities.
- Managed high-volume insurance verifications within pressured timeframes for productive medical operations.
- Collaborated with team members to resolve discrepancies in insurance verification, ensuring proper billing practices.
Education
No Degree - Medical Coding And Billing
Downey Adult School
Downey, CA01.2019
High School Graduate -
City of Angels Independent Study
01.2011
Skills
- CMS-1500 claim processing
- ADA compliance forms
- ICD-10 coding experience
- Medical coding expertise
- HCPCS coding accuracy
- Knowledge of clinical terminology
- Medicaid knowledge
- TRICARE and CHAMPVA expertise
- Knowledgeable in PPO, HMO, EPO, and IPA structures
- Knowledge of workers' compensation regulations
- TARs/ CIFs/ RTDs/ Appeals
- Customer engagement
- Medical claims processing
- Insurance claims processing
- Collections management
- Detail-oriented data management
- Appointment coordination
- Troubleshooting expertise
- Client interaction proficiency
Languages
Spanish
Native or Bilingual
Timeline
Customer Service Representative Sr
United Healthcare
10.2023 - 06.2025
Patient Engagement Representative
Riverside Medical Clinic
05.2021 - 09.2023
Insurance Verifications Specialist
UMIH Downey
10.2019 - 02.2021
High School Graduate -
City of Angels Independent Study
No Degree - Medical Coding And Billing
Downey Adult School
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