Ericka Marthel
Houston,TX
Summary
With a proven track record at Teladoc Health, excellent in customer support and critical thinking, enhancing client satisfaction through effective complaint resolution and privacy safeguarding. Experience in data entry and active listening has significantly improved service delivery, demonstrating a goal-oriented mindset that consistently exceeds employer expectations.
Customer Service Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, ad providing customized solutions to build loyalty.
Overview
8
8
years of professional experience
1
1
Certification
Work History
Mental Health Service Rep
Teladoc Health
03.2024 - Current
- Increased customer satisfaction by addressing and resolving complaints in a timely manner.
- Manage 50 incoming cases including emails, voicemails or internal requests from other departments within Teladoc.
- Handled customer complaints quickly and professionally to restore customer confidence and prevent loss of business.
- Demonstrated mastery of comprehensive safety, resiliency and mental health assessments.
- Developed and maintained positive customer relations and coordinated with team members to properly handle requests and questions.
- Conducted telepsychiatry consultations, increasing access to mental health services for remote patients.
- Assist the customer Service Reps with escalated Mental Health patients. Ex. Urgent appointments, unsatisfied members etc.
- Reduced scheduling conflicts by closely monitoring deadlines and proactively rescheduling appointments as needed.
- Collaborated with cross-functional teams to create comprehensive schedules that met project timelines and budget constraints.
- Safeguarded customer data privacy through strict adherence to company protocols when working with sensitive information.
- Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility, and claims.
Customer Service Representative
Acclara Solutions
09.2023 - 03.2024
- Determine assistance needed (i.e., benefit and eligibility, billing and payments, authorization or treatment, EOBs, etc.) and take appropriate action on the related accounts in timely manner while upholding a high level of professionalism and accuracy.
- Manage 50-100 inbound and outbound calls daily.
- Trained new hire employees
- Assist supervisor's with escalated concerns or patient outreach
- Provide one call resolution to patient inquires
- Review incoming correspondence, taking appropriate and timely action by updating the respective accounts
- Always comply with HIPAA and other compliance requirements to protect patient confidentiality
- Ability to resolve payer rejections and denials through the appeals process as required by each payer's contracting agreements
- Responsible for working payer correspondence, edits, and aged accounts receivable, identifying, and correcting billing errors.
- Resolves unpaid/under-paid claims and collections on behalf of clients.
- Review the Payment Plan, No Statement, Special Handling, Expired, and Bankruptcy tickler queues designated for follow up, taking appropriate action
- Review claims sent from health insurance
- Assist patients with understanding some of the details on EOB
- Make adjustments and write off on a outstanding balance
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
Social Services Assistant
Shadelands Post Acute
04.2019 - 09.2023
- Developed educational materials on various social issues to inform both clients and broader community about available resources.
- Participated in ongoing training opportunities, staying current on best practices within the field of social services.
- Facilitated successful transitions from institutional settings back into the community through comprehensive discharge planning.
- Developed manual providing information on community resources across county available to families and children.
- Delivered comprehensive therapeutic services to children, adolescents, and adults to support child welfare and prevention
- Monitored progress towards service plan goals.
- Developed and maintained accurate records of programs and services.
- Conducted community workshops to promote different programs and educate public on available services.
- Referred families to shelters, legal resources, and educational programs.
- Provided leadership, guidance and support to staff members.
- Established and maintained relationships with key stakeholders.
- Coordinated with community stakeholders for successful implementation of social and community service initiatives.
- Coordinated individual referrals to obtain community services, advocate for client needs and resolve roadblocks.
- Collaborated with community members to develop and implement service initiatives.
- Partnered with local organizations to expand access to social and community services.
- Provided empathetic support to clients during crisis situations, facilitating timely interventions by relevant professionals.
- Coordinated appointments between clients and essential service providers while remaining sensitive to individual scheduling constraints.
Patient Service Representative
North Bay Medical Center / Urgent Care
02.2017 - 04.2019
- Participated in ongoing training programs related to HIPAA compliance, maintaining up-to-date knowledge on regulatory requirements.
- Verified insurance eligibility and coverage for patients.
- Manage inbound and outbound calls regarding appointments or Urgent Care needs.
- Handled sensitive patient concerns with professionalism and empathy, fostering an atmosphere of trust within the clinic.
- Filed and maintained patient records in accordance with HIPAA regulations.
- Managed patient registration process, confirming data accuracy and completeness.
- Used Epic software to schedule appointments.
- Maintained a well-organized front desk, contributing to a welcoming environment for patients and visitors.
- Handled customer service inquiries in person, via telephone and through email.
- Assists patients and their families with referrals to in-house and community resources
- Took copayments and assisted with insurance benefits. Deductible, coinsurance and out of pocket expenses .
- Use government websites to verify coverage details. Medi-cal and Medicare patients.
Education
High School Diploma -
Fairfield High School
Fairfield, CA06.2008
Skills
- Customer support
- Goal-oriented mindset
- Customer relations
- Data entry proficiency
- Staff training
- Client services
- Records management
- Paperwork processing
- Telephone reception
- Client relationship building
- Active listening
- Critical thinking
- Data entry
Certification
- First Aid/CPR Certified
Software or Systems Used
- Epic Software
- Work day system
- ADP
- Microsoft Systems
Timeline
Mental Health Service Rep
Teladoc Health
03.2024 - Current
Customer Service Representative
Acclara Solutions
09.2023 - 03.2024
Social Services Assistant
Shadelands Post Acute
04.2019 - 09.2023
Patient Service Representative
North Bay Medical Center / Urgent Care
02.2017 - 04.2019
- First Aid/CPR Certified
High School Diploma -
Fairfield High School
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