Emilio Rivera
Wesley Chapel
Summary
Dynamic account lead and customer service professional with significant experience and success providing essential support and guidance to individuals seeking healthcare assistance. Proficient in addressing member needs through effective communication, empathy, and expertise in healthcare processes. Demonstrated ability to excel in data entry. claims analysis, and care coordination, ensuring the highest level of member satisfaction. Adept at collaborating with multidisciplinary teams and maintaining strict confidentiality while delivering holistic care. Seeking to leverage knowledge and passion for improving patient experiences and outcomes in the Behavioral Health industry.
Overview
9
9
years of professional experience
Work History
Care Guide
Care Guide
11.2021 - Current
- Provide essential support and guidance to members by processing 20-30 daily calls and responding to 30-50 messages .
- Demonstrate proficiency in data entry and claim analysis to ensure the accuracy and efficiency of claims processing.
- Utilize inbound/outbound calls and secure messaging to effectively communicate with geographically specific members
- Coordinate care across diverse settings (outpatient, ER, home care), upholding strict confidentiality and the highest level of professionalism
- Expertly address inquiries related to claims and billing, ensuring members receive timely and accurate information. Actively engage with members by listening to their comments, concerns, and suggestions, and facilitate internal communication to enhance member satisfaction,
Customer Service Representative
Alorica
04.2020 - 11.2021
- Provided exemplary customer service, specializing in banking and credit card services, to address customer inquiries and concerns.
- Proficiently updated customer account information, ensuring accuracy and security.
- Facilitated money transfers and financial transactions with precision and attention to detail.
- Handled a high volume of incoming calls efficiently and professionally.
- Expertly performed data entry tasks to maintain accurate customer records
Customer Service Representative
Aerotek
10.2019 - 03.2020
- Successfully updated patient's personal information with a high degree of accuracy and confidentiality.
- Conducted new member surveys to gather essential information and feedback.
- Assisted members in completing forms, ensuring completeness and compliance.
- Effectively managed and resolved complaint investigations, ensuring customer satisfaction.
- Proficiently updated accounts and maintained accurate records through meticulous data entry.
Mannys Detail
Account Management/ Sales
04.2016 - 05.2019
- Established and managed accounts for new customers, ensuring a smooth onboarding process.
- Handled payroll responsibilities, ensuring accurate and timely compensation for employees.
- Coordinated and organized schedules, optimizing efficiency in day-to-day operations.
- Maintained meticulous record-keeping by filing all essential paperwork promptly.
- Executed various business-related errands, contributing to the seamless operation of the company.
- Resolved customer issues promptly and effectively, ensuring their satisfaction and loyalty.
Patient Specialist
CareCentrix
10.2014 - 03.2016
- Managed and resolved patient issues with a focus on providing top-notch customer service.
- Accurately updated patient's personal information while ensuring data privacy and compliance.
- Conducted new member surveys to gather valuable insights and feedback for improvement.
- Assisted members in navigating and completing necessary forms for streamlined processes.
- Conducted thorough complaint investigations, addressing and resolving issues to enhance patient satisfaction.
- Proficiently updated and maintained accounts with precision and attention to detail.
- Performed data entry tasks with a high degree of accuracy and efficiency.
- Processed and managed claims, ensuring timely and accurate submissions for reimbursement.
Education
No Degree - Human Resources Management
Western Governors University
Salt Lake City, UT10.2024
High School Diploma -
Hillsborough High School
Tampa, FL07.2012
Skills
Project Management
Customer Service
Healthcare Partnerships
Insurance Claims
Care Coordination
Data Analysis Medical Terminology
Data Entry
Written & Verbal Communication
Relationship Building
Microsoft Office (Word, Excel)
Additional Experience
Account Manager | Precise Advertising Inc.-Nov 2013 - Jun 2014
Concierge Specialist | Freedom Health -May 2011 - Nov 2013
Volunteer | St Joseph Hospital - Tampa, FL - Jun 2008 - Jun 2012
Timeline
Care Guide
Care Guide
11.2021 - Current
Customer Service Representative
Alorica
04.2020 - 11.2021
Customer Service Representative
Aerotek
10.2019 - 03.2020
Mannys Detail
Account Management/ Sales
04.2016 - 05.2019
Patient Specialist
CareCentrix
10.2014 - 03.2016
No Degree - Human Resources Management
Western Governors University
High School Diploma -
Hillsborough High School
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