Erica Reyes
Jurupa Valley,Ca
Summary
Driven professional with extensive history in providing excellent customer service in medical or healthcare setting. Reputation for displaying professionalism and high levels of integrity. Proven ability to deliver results quickly.
Overview
19
19
years of professional experience
Work History
Grievance Coordinator, Contigent Case Manager
Kaiser Permanente
03.2023 - 03.2025
- Maintained accurate documentation on all cases, ensuring compliance with regulations and confidentiality requirements.
- Conducted thorough assessments of clients'' situations, identifying issues, goals, and necessary interventions.
- Monitored ongoing cases closely, adjusting case management strategies as needed based on evolving circumstances or new information.
- Improved client satisfaction by efficiently addressing concerns or grievances in a timely manner.
Customer Service Concierge Support, Advanced
Blue Shield of California Promise Health Plan
10.2018 - 09.2022
- Handle escalation cases that are forwarded by member services in which need additional follow up
- Responsible in delivering high quality customer service in an efficient, effective and timely manner
- Make contact with medical groups, billers, doctor offices and vendors to resolve any issues the member might be experiencing
- Assist with claims, authorizations and eligibility
- Inbound and outbound communication with plan membership
- Handling, resolving and following up on member complaints and/or grievances
Customer Service Trainer
Care 1st Health Plan
05.2016 - 10.2018
- Responsible for training new employees on customer service, product operations and other work processes as well as continued development of existing employees
- Responsible to develop call scripts, training manuals and policies that meet compliance/procedures for call center as needed
- Responsible in training all new hire personnel to assure they meet performance goals and department standards
- Responsible for the implementation of new systems within the member services department
- Conduct quality assessments for member services representatives
- Evaluated areas of improvement and implemented quality improvement plans
Member Service Representative
Care 1st Health Plan
11.2009 - 05.2016
- Assist with Medi-cal, Medicare and Cal-Medi Connect member calls while maintaining company service level and exceeding monthly stats
- Responsible for dissemination of plan information regarding, benefit coverage and any other information needed
- Handling and following up on member complaints and/or grievances
- Deescalate any irate members and sympathize to find the best solution to ensure that they receive the best care
- Provide member eligibility and benefits to providers
Scheduling Secretary
Doheny Eye Medical Group
05.2006 - 11.2009
- Responsible for answering and directing incoming calls
- Retrieve messages and scheduling patient appointments for up to twelve ophthalmology specialists
- Registering new patients using an IDX program
- Verify insurance eligibility prior to all patient visits
- Scan office documents into the Core system
- Relieved front desk staff personnel and prepared patient charts for clinic
Education
Diploma - Medical Assisting
Bryman College
Los Angeles, Ca01.2022
Diploma - General Education
James A Garfield High School
Los Angeles, Ca01.1999
Skills
- Medical terminology
- Bilingual
- Communication skills
- Diplomatic skills
- Attention to detail
- Multi-tasking
- Teamwork
- Project management
- Superior work ethics
- Adaptability
- Commitment to patient health and well being
Timeline
Grievance Coordinator, Contigent Case Manager
Kaiser Permanente
03.2023 - 03.2025
Customer Service Concierge Support, Advanced
Blue Shield of California Promise Health Plan
10.2018 - 09.2022
Customer Service Trainer
Care 1st Health Plan
05.2016 - 10.2018
Member Service Representative
Care 1st Health Plan
11.2009 - 05.2016
Scheduling Secretary
Doheny Eye Medical Group
05.2006 - 11.2009
Diploma - Medical Assisting
Bryman College
Diploma - General Education
James A Garfield High School
Similar Profiles
MICHAEL NAVAMICHAEL NAVA
Area Director at Kaiser Permanente – The Permanente Medical GroupArea Director at Kaiser Permanente – The Permanente Medical Group
Johnica M. BennettJohnica M. Bennett
Director of Midwifery Services at Kaiser Permanente- Mid Atlantic Permanente Medical GroupDirector of Midwifery Services at Kaiser Permanente- Mid Atlantic Permanente Medical Group
JAMES O'BRIENJAMES O'BRIEN
Family Physician at Northwest Permanente (Kaiser Permanente)Family Physician at Northwest Permanente (Kaiser Permanente)
Rachel PerryRachel Perry
Communications Operator at Kaiser Permanente (Kaiser Foundation Hospitals)Communications Operator at Kaiser Permanente (Kaiser Foundation Hospitals)
Christine RodriguezChristine Rodriguez
Amazon Warehouse picker at Amazon WarehouseAmazon Warehouse picker at Amazon Warehouse