Gloria Zavala Montoya
Santa Fe Springs,CA
Summary
Summary of Qualifications: Experienced bilingual Customer Service Representative with a thorough understanding of client services within fast paced environments. Recognition with nomination as Employee of the year/Employee of the month as a consistently strong professional with the skills and talent necessary to maintain positive client relations while increasing sales and customer satisfaction.
Overview
9
9
years of professional experience
Work History
OUTPATIENT CARE COORDINATOR II
Prospect Medical Systems
Orange, California
10.2017 - 06.2025
- Accurately enter all data from medical record review, into Cozeva’s supplemental data module. Provide general education to encourage the member to complete the required, “due” quality measures. Manage assigned member outreach (appointment reminder calls, quality measures due, annual wellness visits, follow-up calls.) by conducting telephone calls and/or in-person visits to members for all lines of business, to close gaps in care and increase HEDIS/IHA/STAR scores.
CUSTOMER SERVICE HEDIS TEMP
MOLINA HEALTHCARE
11.2016 - 04.2017
- Conducted 60 to 90 outbound/inbound calls daily to execute preventive measures aligned with NCQA standards.
- Closed all due measures for members, ensuring compliance with reporting standards and assisting PCP and specialists with queries regarding due reports.
- Completed day-to-day duties accurately and efficiently.
- Contributed innovative ideas and solutions to enhance team performance and outcomes.
- Worked successfully with diverse group of coworkers to accomplish goals and address issues related to our products and services.
Education
High School Diploma -
Woodrow Wilson High
Los Angeles, CA06-1985
Skills
- Data entry
- MS Word
- Bilingual-Spanish
- Quality measure management
- Care coordination
- Medical record review
- Telephone outreach
- Customer relationship
- Patient engagement
- Attention to detail
- Team Player
- Time management
- Problem-solving
- Verbal and written communication
- Appointment scheduling
- Training and mentoring
- Database coordination
- Patient education
- Adaptability and flexibility
- Problem-solving abilities
- Records maintenance
- Multitasking and organization
Timeline
OUTPATIENT CARE COORDINATOR II
Prospect Medical Systems
10.2017 - 06.2025
CUSTOMER SERVICE HEDIS TEMP
MOLINA HEALTHCARE
11.2016 - 04.2017
High School Diploma -
Woodrow Wilson High