Summary
Overview
Work History
Education
Skills
Timeline
Generic

ISABELLE MUCURA

Las Vegas,NV

Summary

Diligent professional with over 10+ years of experience in customer service and 6+ years in healthcare industry. Looking to secure a challenging position in a reputable organization to expand my learnings, knowledge and skills.

Overview

13
13
years of professional experience

Work History

AHG REP

Anthem Inc
05.2021 - Current
  • Maintain customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
  • Provide primary members support to internal and external members.
  • Collect members feedback and make process changes to exceed member satisfaction goals.
  • Document accurate information in database thoroughly for accurate tracking and analysis .
  • Research and analyze data to address challenges and member service issues.
  • Multi tasking, navigating multiple computer applications while efficiently communicating and serving the member.
  • Troubleshoot members portal accounts
  • Inbound/outbound call handling

Referral Specialist II

Aim Specialty Health/Anthem
09.2015 - 05.2021
  • Acts as a liaison between patients, hospitals, health plans, physicians, vendors and other referral programs.
  • Maintained accurate records on in-progress and completed referrals, ensuring full data integrity throughout process.
  • Handles health plan verifications, completes pre authorization process for sleep management therapy, radiation oncology therapy and other imaging exams such as CT, MRI, MRA, PET, SLEEP et.
  • Take inbound calls to initiate exams request following established process, meets quality and standard production.
  • Called insurance companies to get precertification and other benefits information on behalf of patients.

Caregiver/Personal Assistant

Right At Home
08.2018 - 01.2019
  • Kept household areas clean and well-stocked, ran errands, managed laundry and completed weekly grocery shopping.
  • Built strong relationships with clients to deliver emotional support and companionship.
  • Kept close eye on client vital signs, administered medications and tracked behaviors to keep healthcare supervisor well-informed.

Customer Service Manager

Wal-Mart
03.2011 - 12.2015
  • Reviewed repeated issues within operations and business management to solve problems and improve company outcomes.
  • Exceeded team goals and collaborated with staff members to implement customer service initiatives.
  • Resolved customer complaints while prioritizing customer satisfaction and loyalty.
  • Supervised employees and assessed performances to determine training needs and define accurate plans for decreasing process lags.
  • Took ownership of customer issues and followed problems through to resolution.
  • Assumed ownership over team productivity and managed work flow to meet or exceed quality service goals.
  • Assisted with pricing questions, inventory availability and changes to existing order and shipping information.
  • Monitored customer service operations to assess agent performance and provide feedback.

Education

Associate of Science - Health Administration

Colorado Technical University
Colorado Springs, CO

Skills

  • Verbal and written communication
  • Pre-authorizations
  • Detail-oriented
  • Insurance coding (ICD10 and CPT)
  • Supervision
  • Medical terminology
  • Multiple application computer skills
  • Critical thinking
  • Data Entry Software
  • Building Customer Trust and Loyalty
  • De-escalation Techniques
  • Strong Analytical and Problem Solving Skills
  • Claims Knowledge
  • Customer Service Experience
  • Processing Policies

Timeline

AHG REP

Anthem Inc
05.2021 - Current

Caregiver/Personal Assistant

Right At Home
08.2018 - 01.2019

Referral Specialist II

Aim Specialty Health/Anthem
09.2015 - 05.2021

Customer Service Manager

Wal-Mart
03.2011 - 12.2015

Associate of Science - Health Administration

Colorado Technical University

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ISABELLE MUCURA