Esperanza Duran
Las Cruces,NM
Summary
Detail-oriented professional with extensive experience managing high-volume calls in the insurance sector, emphasizing compliance and quality assurance. Effectively assisted Medicare beneficiaries with Coordination of Benefits inquiries, ensuring accurate information on coverage and claims. Maintained HIPAA-compliant documentation while resolving member concerns, enhancing customer satisfaction and operational efficiency.
Overview
6
6
years of professional experience
3
3
years of post-secondary education
Work History
Call Center Representative
Centers for Medicare & Medicaid Services COB&R
Las Cruces, NM
05.2024 - Current
- Managed high-volume calls effectively, ensuring compliance with federal regulations and maintaining quality assurance standards.
- Managed a high volume of inbound calls daily while assisting Medicare beneficiaries with Coordination of Benefits and Recovery Center inquiries.
- Answered incoming calls from customers and provided assistance with product inquiries, billing questions, and other customer service related issues.
- Answered incoming calls and provided highest level of professionalism and knowledgeable service to every customer.
- • Provided accurate information regarding Medicare coverage, insurance updates, and claim-related questions.
- • Resolved member concerns professionally while maintaining high customer satisfaction.
- • Documented calls thoroughly using internal systems while maintaining confidentiality and HIPAA compliance.
- • Updated all MSP records, including NGHP/GHP, and dealing with the recovery center to protect the Medicare trust fund.
Caregiver
Simplicity Home Care
Las Cruces, New Mexico
04.2023 - 04.2024
- Provided compassionate personal care, assisting clients with daily living activities to enhance their quality of life.
- Administered medications and monitored vital signs, ensuring compliance with care plans
Mental Health Technician
Mesilla Valley Hospital
Las Cruces, NM
05.2021 - 03.2023
- Provided crisis intervention and de-escalation techniques to help manage patient behavior.
- Monitored patient behavior and provided support to ensure safety and compliance with treatment plans, enhancing patient well-being.
- Developed and maintained accurate patient records and documentation, facilitating effective communication among the healthcare team.
Caregiver, Special Needs
Campo Behavioral Health
Las Cruces, NM
05.2020 - 04.2021
- Assisted individuals with special needs in daily living activities, enhancing their independence and overall well-being.
- Documented daily activities and progress notes, maintaining accurate records for client assessments and evaluations.
Education
High School Diploma -
Rio Grande Prepretory Institue
Las Cruces, NM 05.2016 - 05.2019
Some College (No Degree) - Medical Billing & Coding
Dona Ana Community College
Las Cruces, NMSkills
- Insurance verification
- Coordination of benefits
- Medicare knowledge
- Microsoft Word, Excel, Outlook
- Call center phone systems
- Multi-screen navigation
- Strong communication and listening skills
- Fast learner with attention to detail
- Empathetic and patient-centered
- Data entry
Timeline
Call Center Representative
Centers for Medicare & Medicaid Services COB&R
05.2024 - Current
Caregiver
Simplicity Home Care
04.2023 - 04.2024
Mental Health Technician
Mesilla Valley Hospital
05.2021 - 03.2023
Caregiver, Special Needs
Campo Behavioral Health
05.2020 - 04.2021
High School Diploma -
Rio Grande Prepretory Institue
05.2016 - 05.2019
Some College (No Degree) - Medical Billing & Coding
Dona Ana Community College