Summary
Overview
Work History
Education
Skills
Languages
Accomplishments
Reference
Timeline
Generic

Esmeralda Ramirez

Santa Ana,CA

Summary

Detailed Client Service Associate, known for having great organizational skills. Gifted at working with all types of customers. Looking for a new role where hard work and dedication will be highly valued. Personable and dedicated customer service representative with extensive experience in industry. Solid team player with upbeat, positive attitude and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Articulate, enthusiastic and results-oriented with demonstrated passion for building relationships, cultivating partnerships and growing businesses.

Overview

9
9
years of professional experience

Work History

Customer Service Representative/Provider Specialist

Nations Benefits
Costa Mesa, California
10.2022 - Current
  • Supported Medicare Advantage and Medicaid members by coordinating supplemental benefit services, including OTC, healthy foods, and flex card programs.
  • Served as the primary liaison between healthcare providers and internal departments to ensure timely scheduling, service authorization, and claims processing for hearing and supplemental benefit services.
  • Resolved complex problems by working with other departments to provide solutions that meet customer needs.
  • Educated members about the features of different types of hearing aids available in the market.
  • Participated in daily huddles with team members in order to discuss common goals and objectives.
  • Scheduled appointments for patients requiring additional services or follow-up care.
  • Answered customer inquiries regarding billings, payments, account status.
  • Developed and maintained strong relationships with providers by responding promptly to inquiries, resolving issues and providing ongoing support.
  • Utilized internal systems (e.g., CRM platforms, proprietary portals, EHR systems, Outlook, Excel).
  • Delivered high-volume inbound and outbound support to health plan members, resolving complex issues related to OTC, healthy food, and hearing benefits.
  • Managed provider inquiries related to service authorizations, reimbursements, billing, and maintaining compliance with CMS and HIPAA guidelines.
  • Implemented tracking mechanisms to ensure order accuracy and delivery compliance across multiple benefit platforms.
  • Trained new providers on NationsHearing's processes and digital platforms, enhancing provider engagement, and reducing onboarding time.

Receptionist/Customer Service Representative

JNR
Irvine, CA
05.2021 - 10.2022
  • Key holder: opening/closing procedures, and maintained an organized and professional waiting area.
  • Warmly welcomed 10 to 15 guests per shift, coordinated check-in, collected paperwork, and directed them to their destination.
  • Managed six phone lines and facilitated over twenty calls with clients, vendors, and staff.
  • Answered inbound chats and emails to facilitate customer service, and scheduled travel team meetings.
  • Provided administrative and clerical support via EMR systems and Microsoft Excel.
  • Coordinated pick-up and delivery of express mail services, unpacked inventory, and stocked supplies.
  • Deactivation files for employees who are no longer with the company.
  • Requesting monthly AC maintenance, facility requests, and validating parking passes for visitors to exit the building.

Cashier/Team Lead/Sales Associate

Gap/Baby Gap
Costa Mesa, CA
10.2018 - 02.2022
  • I offered customers product advice on a specific product.
  • Trained new team members in cash register operation, stock procedures, and customer service.
  • Helped with purchases, and signed customers up for the rewards program and store credit card.
  • Tracked company inventories, moved excess stock, and arranged products to improve sales.
  • Helped fellow cashiers resolve technical, service, and customer issues to maintain team efficiency and customer satisfaction.
  • Authorized discounts and special actions to resolve customer disputes, and maintain satisfaction.
  • Motivated and goal-oriented about being one of the top three in store credit card sales and the loyalty reward program. (200+)

Cashier/Cashier/Sales Associate

Tilly's
Costa Mesa, CA
11.2016 - 08.2018
  • Maintained the sales floor by restocking shelves, updating pricing information, and managing inventory.
  • I explained the return and exchange policy to enforce, and accepted merchandise for refunds or replaced items.
  • Operated the cash register by adhering to POS system processes and procedures when ringing up sales.
  • Escalated customers' complaints or inquiries to management for immediate investigation and resolution.
  • Learned the roles of other departments to provide coverage and keep the store operational.

Education

BBA - Business Administration and Management

Orange Coast College
Costa Mesa, CA

Skills

  • Inbound/outbound calling
  • Data evaluation
  • Microsoft Office expertise
  • Product and service solutions
  • Quality control
  • Problem-solving abilities
  • Escalation management
  • [Software] CRM system proficiency
  • Payment processing

Languages

English
Native/ Bilingual
Spanish
Native/ Bilingual

Accomplishments

  • Created highly effective new program that significantly impacted efficiency and improved operations.
  • Consistently generated additional revenue through skilled sales techniques.
  • Assisted customers over the phone regarding store operations, product, promotions and orders.
  • Exceeded sales goals by average of 90% in 2021.
  • Maintained queue scores of 90% + over, exceeding departmental performance standards for response time, accuracy, and resolution.

Reference

  • Abigail Onofre (714) 589 - 0898
  • Alyssa Medrano (714) 325-4114

Timeline

Customer Service Representative/Provider Specialist

Nations Benefits
10.2022 - Current

Receptionist/Customer Service Representative

JNR
05.2021 - 10.2022

Cashier/Team Lead/Sales Associate

Gap/Baby Gap
10.2018 - 02.2022

Cashier/Cashier/Sales Associate

Tilly's
11.2016 - 08.2018

BBA - Business Administration and Management

Orange Coast College

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