Guadalupe Estrada
San Antonio,Texas
Summary
Pursuing full-time role that presents professional challenges and leverages interpersonal skills, effective time management, and problem-solving expertise.
Overview
2
2
Languages
1
1
Certification
14
14
years of professional experience
Work History
Legal Customer Service
Claimfox
San Antonio, Texas, United States
11.2024 - Current
- -Created document requests to facilitate timely access for clients
- -Also ensure company system had proper documentation of request entry
- -Compressed documents into zip files and billed requestors for efficient delivery
- -Ensured proper documentation was maintained in company system for all request entries.
Customer Services Representative
Eteam
San Antonio, Texas, United States
09.2020 - Current
- Handle all customer contacts in a professional and courteous manner.
- Account set up, customer pricing, required quality or export documentation or certificates. Identify and coordinate resolution of any issues that may negatively affect customer satisfaction. Input customer orders received via all contact methods. Review orders received for accuracy and completeness, confirm and/or correct customer orders prior to enter in ERP system.
- Account set up, customer pricing, required quality or export documentation or certificates. Provided support for operationsdentify and coordinate resolution of any issues that may negatively affect customer satisfaction. Input customer orders received via all contact methods. Review orders received for accuracy and completeness, confirm and/or correct customer orders prior to enter in ERP system.
- Processed requests for credit, rebill, and returns.
- Collaborated with Supply Chain to ensure on-time delivery and meet or exceed established order accuracy and turnaround standards.
- Managed all customer interactions with professionalism and courtesy, enhancing customer experience.
- Comply with all Company, Departmental, and applicable Quality System work instructions, procedures, and policies.
- -Manage short supply situations, backorders and manual allocations as required. Input and manage orders for exception products requiring special handling. Compose accurate, prompt, and appropriate replies to all customer contacts.
- -Enter all contact information into appropriate database(s) in compliance with Company and
- Regulatory policies
- Ensure that all potentially serious incidents are raised to the appropriate levels of Management.
- Resolved service complaints to customer satisfaction while adhering to established company guidelines.
- Handle all complaints according to FDA/ISO/cMDR and other regulations governing medical devices and HIPAA regulation
- .
Customer Service
HealthCare support
San Antonio, Texas, United States
11.2019 - 08.2020
- Developed and implemented customer service initiatives that reduced wait times.
- Assisted customers by responding to inquiries, resolving complaints, forwarding issues to appropriate sections, and providing information about insurance policies.
- Served as medical insurance overpayment specialist from May 2019 to July 2019
- West Corporation, San Antonio, TX
- Maintained knowledge of benefits claim processing, claims principles, medical terminology and procedures and HIPAA regulations.
- Displayed consistent, positive attitude towards customers, peers and other personnel, even during high-stress situations.
- Resolved problems, improved operations and provided exceptional service
- Referenced administrative guidelines to address questions regarding medical claims processing.
- Maintained a positive attitude towards customers, peers, and personnel, even in high-stress situations.
- Evaluated accuracy and quality of data entered into agency management system. . Paid or denied medical claims based upon established claims processing criteria.
- Reviewed provider coding information to report services and verify correctness.
Medical Insurance Overpayment Specialist
West Corporation
San Antonio, Texas, United States
05.2019 - 07.2019
- Make outbound calls and receive calls from individuals in the billing department of a hospital, medical facility, and three
- Party billing companies to collect funds owed, confirm, or
- Obtain additional details on a medical claim in order to pursue
- An insurance overpayment and set up payment plans and provide information (by fax, email, or phone) to necessary
- Parties to render payment on accounts
Bilingual Customer Service Advisor
Conduit Global Call Center
San Antonio, Texas, United States
08.2018 - 03.2019
- Knowledgeable of Verizon Wireless Prepaid promotions, Devices, discounts, plans, and
- Ensured customer satisfaction by systematically troubleshooting technical problems.
- Ensuring that I "Deliver the Promise " in each call also follow company policies and guidelines to ensure each customer is satisfied with the resolution and actions taken
- Assisted customers with billing questions and clarified billing processes.
- Conduct various reports in order to ensure the customer is under the right plan. Explaining to the customer how the billing works within our system and also making sure Auto Pay recipients were
- 100% activated to ensure maximum quality
- Provide thorough technical support and problem
- Resolution for customers.
Pharmacy Technician Trainee
CVS Caremark
San Antonio, Texas, United States
12.2015 - 02.2018
- Leading all member and provider interactions over the phone. Verify all patient and drug information
- Entered patient and drug information accurately, checking for errors and potential interactions, reporting findings to pharmacist.
- Executed criteria-based prior authorization process, ensuring timely and precise documentation of all approvals and denials.
- Managed the review and decision-making process for claims approvals and denials., transferring all clinical questions to pharmacist. Select Accomplishments:
- ➜ Promoted efficient communication flow across pharmacy by maintaining detailed notes
- Positive customer experience while modeling customer service best practices.
- Frequently updating customer accounts as needed, and communicating all issues, areas of concern
- And improvement suggestions.
- ➜ Uphold compliance to company, state, and federal regulations, staying up to date on new and revised laws and procedures.
Digital Marketing Sales Representative
Charlie Clark Nissan Brownsville
Brownsville, Texas, United States
06.2015 - 11.2015
- Promoted within 1 month for driving increased sales and enhancing customer response rate.
- Identified sales opportunities, conducted cold calls, and resolved customer issues effectively.
- Maintained sales pipeline and updated CRM database with accurate information on all activities.
- Secured new business by identifying leads and finalizing sales agreements. Select Accomplishments:
- Maintained sales pipeline and accurate information in CRM database, updating all activity including
- Leads and closes. Select Accomplishments:
Personal Attendant/Home Health Provider
Bee First Primary Home Care
Harlingen, Texas, United States
08.2012 - 11.2015
- Provided daily care assistance, including companionship and conversation, to enhance quality of life for individuals.
- Delivered essential health care support, hygiene, and additional services to promote patient health and wellbeing.
- ➜ Maintained accurate daily log, observing, recording, and reporting changes to supervisor.
- Maintained daily log, observing and recording changes, and reported findings to supervisor to ensure continuity of care.
Hospital Billing Clerk
South Heart Clinic
Harlingen, Texas, United States
08.2013 - 06.2015
- Ensured communication, quality assurance, and accuracy standards for all data management.
- Prepared and updated invoices, reconciliations, payments, adjustments, medical records, and patient demographic data to maintain compliance with HIPAA and relevant regulations.
- Maintained compliance with HIPAA, organizational, state, and federal regulations in all billing processes.
- Privacy and regulations. Accurately entered patient information, procedure, and diagnosis codes into
- Billing software (NueMD). Verified and coded narrative diagnoses, adding necessary modifiers.
- Outlined significant contributions to billing accuracy and efficiency.
- ➜ Verified and acquired patient information and insurance authorizations for billing, procedures
- And tests ordered by Physicians; completed 1500+ claims.
Education
Certification - Medical Billing and Coding
Southern Careers Institute Harlingen
Harlingen, Texas, United States01-2013
Diploma - dipolma
Harlingen South High School
Harlingen, Texas, United States01-2012
Skills
- Claims
- Payments
- Medicaid
- Clerk
- Reconciliations
- Adjustments
- Forecasting
- Cash Management
- Healthcare
- Pharmacy
- Medical Billing
- Clarify
- CRM
- Technical Support
- Billing
- Database
- CVS
- Hipaa
- Wireless
- Flash
- Coding
- Customer Service Oriented
- Customer Service
- Greeting
- Federal Regulations
- Invoices
- Invoicing
- Front Desk
- Medical Records
- Data-Entry
- Customer Accounts
- Sales Representative
- Outbound Calls
- Customer Service Representative
- Verizon
- Medical Insurance
- Hospital Billing
- Best Practices
- Documentation
- Bilingual
- Bilingual
- Inventory
- Quality Assurance
- Medical Billing & Coding
- Medical Invoicing
- Retail Sales
- Digital Marketing
- Digital Campaign
- Maintenance
- Pipeline
- Customer Relationship Management
- Toxicology
- Pharmacology
- Excel
- Microsoft Powerpoint
- Powerpoint
- Wordperfect
- Customer Support/Service
- Order Management
- Resolve Customer Issues
- Problem Solving Skills
- Legal
- Zip
- Medical Treatment
- Healthcare Providers
- Insurance
- Data Quality
- Analysis Skills
- Claims Processing
- Health Insurance
- Medical Terminology
- HIPAA (Health Insurance Portability and Accountability Act)
- Operational Improvement
- Regulations
- Identify Issues
- Customer Response
- Medical Protocols
- Code Reviews
- Hospital
- Multilingual
- Wireless Communications
- Customer Satisfaction
Certification
Certification to be a Pharmacy Tech Trainee, Medical Billing
LANGUAGES
English - Fluent
Spanish - Intermediate
WORK AUTHORIZATION
- I am authorized to work in the following countries:
- United States
Personal Information
Title: Customer Services Rep
Timeline
Legal Customer Service
Claimfox
11.2024 - Current
Customer Services Representative
Eteam
09.2020 - Current
Customer Service
HealthCare support
11.2019 - 08.2020
Medical Insurance Overpayment Specialist
West Corporation
05.2019 - 07.2019
Bilingual Customer Service Advisor
Conduit Global Call Center
08.2018 - 03.2019
Pharmacy Technician Trainee
CVS Caremark
12.2015 - 02.2018
Digital Marketing Sales Representative
Charlie Clark Nissan Brownsville
06.2015 - 11.2015
Hospital Billing Clerk
South Heart Clinic
08.2013 - 06.2015
Personal Attendant/Home Health Provider
Bee First Primary Home Care
08.2012 - 11.2015
Diploma - dipolma
Harlingen South High School
Certification - Medical Billing and Coding
Southern Careers Institute Harlingen