Highly proficient senior customer service representative with demonstrated customer service orientation and interpersonal and communication skills to effectively handle multiple tasks in a fast-paced environment. A quality-focused producer consistently meets team and department production targets by delivering strong output to achieve metrics. Mentors new hires and existing staff in call handling best practices to promote accurate and consistent call responses.
Overview
20
20
years of professional experience
Work History
Senior Customer Service Representative Benefit Ops
United Health Group, Inc.
9900 Bren Road East; Minnetonka, MN 55343
08.2024 - Current
Demonstrated excellent multitasking abilities by managing multiple concurrent tasks while ensuring timely completion.
Enhanced customer satisfaction by promptly addressing and resolving complex inquiries and complaints.
Utilized CRM tools effectively for efficient tracking and reporting of customer interactions and outcomes.
Developed comprehensive knowledge of company products and services in order to provide accurate information to customers.
Consistently exceeded performance targets, earning recognition as a top-performing Senior Customer Service Representative on multiple occasions.
Developed solutions-oriented approaches when faced with challenging situations or dissatisfied customers.
Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Clinical Administrative Coordinator
Optum (United Health Care)
11.2021 - Current
Provide excellent and empathetic telephonic customer service for providers/patients
Utilize critical thinking and effective communication to help connect the value of the Landmark
Serving as the primary point of contact for providers or members regarding medical/ behavioral/clinical services or benefits
Extract and review fax requests for medical and clinical services
Check procedure codes against notification requirements and benefit coverage to determine the next steps
Provide information regarding appointments and medical services to facilities staff to assist members
Process clinical trial requests for chemotherapy and radiation therapy requests
Assist in confirming and validating provider and facility information to ensure accurate data entry into our internal systems.
Patient Service Advocate/ Floor Coordinator
New York Hotel Trades
07.2006 - 01.2021
Streamlined appointment scheduling processes for increased efficiency and reduced wait times
Facilitated communication between healthcare providers by liaising with patients with complex cases requiring interdisciplinary coordination
Maintained accurate patient records, ensuring confidentiality and compliance with HIPAA regulations, and processed requests for medical records by patients, providers, and third-party providers
Coordinated care between providers, facilitating efficient treatment plans that met patient needs
Trained inexperienced staff members on office policies, procedures, and best practices for Patient Service Advocates
Secured patient information and confidential medical records in compliance with HIPAA privacy rules to protect patient privacy.
Assistant Archivist/Assistant
City University of New York-Dominican Studies Institute
10.2004 - 07.2006
Create a list of prospective donors & conduct interviews
Entering interview information into the database
Upkeeping/updating office inventory
Help arrange travel and itinerary for the program director
Processing payment for vendors & contract workers
Payroll processing
Authenticated and appraised over one thousand historical documents and archival materials weekly
Directed two volunteers and employees in cataloging, designing exhibits, and recording artifacts.
Education
Bachelor of Science - Business, Management, & Econ; Minor Healthcare Adm
Suny Empire State College, New York
Saratoga Springs, NY
12.2024
Skills
Bilingual Spanish/English
Computer Skills
Leadership Experience
Strong Written and Oral Communication
Experience with EMR
Experience processing CPT/HCPCS Codes
HIPAA knowledge
Insurance Verification
Policy Implementation
Medical Office Management
Coding Procedures
Administration and Operations
Activities
Since September 2014, I have volunteered as a peer counselor for the Lupus Line program. The Lupus Line offers one-to-one emotional support and education to people with lupus and their families in the New York tri-state region, nationwide, and internationally.
Languages
Spanish
Native or Bilingual
Timeline
Senior Customer Service Representative Benefit Ops
United Health Group, Inc.
08.2024 - Current
Clinical Administrative Coordinator
Optum (United Health Care)
11.2021 - Current
Patient Service Advocate/ Floor Coordinator
New York Hotel Trades
07.2006 - 01.2021
Assistant Archivist/Assistant
City University of New York-Dominican Studies Institute
10.2004 - 07.2006
Bachelor of Science - Business, Management, & Econ; Minor Healthcare Adm