Evelyn Chavez
Montgomery,TX
Summary
Dynamic Senior Customer Service Representative at OptumRx, adept at enhancing patient experiences through effective complaint resolution and quality assurance. Proven ability to manage high-volume calls while ensuring accurate payment processing and insurance verification. Committed to maintaining confidentiality and delivering exceptional support in fast-paced environments.
Overview
13
13
years of professional experience
Work History
Senior Customer Service Representative
OptumRx Mailing Pharmacy
2023.11 - Current
- Responded to a large volume of inbound calls, providing accurate information and support to enhance customer satisfaction.
- Executed medication refill operations, facilitating efficient home delivery services for clients.
- Analyzed insurance eligibility criteria and reviewed benefits to facilitate informed decision-making for clients.
- Collected and organized demographic information to facilitate account setup and enhance user profiles.
- Achieved effective communication with pharmacists and doctor offices through proactive outbound calls, improving patient care coordination.
- Monitored and updated prior authorization status to ensure timely approvals and enhance service delivery.
- Managed patient payment transactions, ensuring accuracy and compliance with billing procedures.
Patient Care Coordinator
Healthy Smiles for Kids of Orange County
2013.08 - 2023.09
- Coordinated patient appointments and follow-ups to enhance overall care delivery.
- Assisted in managing patient records using electronic health record systems for accuracy.
- Educated families on treatment options and care plans to improve patient understanding.
- Collaborated with dental professionals to streamline workflow and enhance patient experience.
- Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
- Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
Education
Dental Assistant
UEI College
Anaheim, CASkills
- Customer support
- Complaint resolution
- Quality assurance
- Payment processing
- Call center experience
- Problem resolution
- Inbound call management
- Remote office availability
- Administrative and office support
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Senior Customer Service Representative
OptumRx Mailing Pharmacy
2023.11 - Current
Patient Care Coordinator
Healthy Smiles for Kids of Orange County
2013.08 - 2023.09
Dental Assistant
UEI College