Esmeralda Esparza
Las Vegas,NV
Summary
Qualified advocate with robust background in provider services. Proven track record of resolving provider inquiries and facilitating smooth communication between providers and healthcare organizations. Demonstrated ability to utilize problem-solving and communication skills to enhance provider satisfaction and operational efficiency.
Overview
3
3
years of professional experience
Work History
Provider Services Representative
United Healthcare Group
11.2022 - Current
- Handle incoming calls or inquiries from providers in doctor's office.
- Highly qualified provider service experience.
- Working knowledge with computers and windows PC applications.
- Experience in Microsoft office programs.
- Provide providers additional information with explanation on benefits and eligibility of a member.
- Assist providers with better understanding on a claim denial.
- Work effectively through chats to support providers inquires.
- Knowledge in plan types such as Medicare and Retirement, as well as commercial policies.
- Knowledge in submitting authorization for pre-services.
- Identify claims in need of re-processing for proper denial.
- Work effectively through remote excelling in self-efficiency.
Customer Service Supervisor
PennyMac Loan Services
07.2021 - 11.2022
- Handle incoming calls and inquiries from prospective customers or clients.
- Highly qualified customer service experience.
- Experience in proper communication to customers on their home mortgages.
- Able to achieve sales objectives through effective account management and commitment to customer satisfaction.
- Coach clients on impactful financial decisions.
- Complete supporting paperwork and data entry as required for customers.
- Trained in audits in preparation for the state.
- Offer sales in refinancing purchasing new homes.
- Offer sales in insurance reduction programs.
- Handle escalated calls.
Education
Associate of Arts - Social Worker
College of Southern Nevada
Las Vegas, NV07-2018
High School Diploma -
Valley HIgh School
Las Vegas, NV07-2016
Skills
- Medicare knowledge
- Healthcare Industry Knowledge
- Claims re-processing
- Commercial plans knowledge
- Call center experience
- Insurance Verification
- Provider Relations
- Customer Service
- Problem-Solving
- Time Management
- Multitasking
- Reliability
Accomplishments
- Received many bravo's/ recognition's in achievements done for the company while providing excellence service to providers on the phone.
Timeline
Provider Services Representative
United Healthcare Group
11.2022 - Current
Customer Service Supervisor
PennyMac Loan Services
07.2021 - 11.2022
Associate of Arts - Social Worker
College of Southern Nevada
High School Diploma -
Valley HIgh School
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