Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
5
5
years of professional experience
Work History
Eligibility Technician
Social Services Agency
10.2023 - Current
Utilize Microsoft Office Programs, including : OneNote, Excel, Outlook, Teams, Etc.
Ensure correct documentation and Record Keeping Focus on the details of work content and work steps/processes
Ensure the confidentiality of client records to comply with Health Insurance Portability and Accountability Act (HIPAA), Personally Identifiable Information (PII), and State/Federal regulations
Provide clear communication both orally and in writing to clients and co workers and/or superiors
Handle difficult and complex situations
Function independently and be able to obtain essential client information, including following up with clients when clarification is needed.
Analyze appropriate program policies, procedures, and/or guidelines
Improved eligibility determination accuracy by implementing efficient data verification processes.
Reduced errors in benefit calculations by conducting thorough reviews of applicant financial information, ensuring consistency with program guidelines.
Collaborated with team members to resolve complex cases, utilizing expertise in regulations and policies to make informed decisions.
Meet deadlines efficiently and timely
Develop and maintain a collaborative work relationship with coworkers Analyze and evaluate the information provided
Possess critical reasoning skills
Streamlined application processing time for faster results, optimizing workflow management and prioritization strategies.
Cashier 3
The Habit
08.2022 - 09.2023
Assist customers with correctly taking their orders
Multi task efficiently by taking orders, starting customer’s drinks, and working expo Correctly double check customer’s orders to ensure no mistakes before giving their order
Run the shift and ensure employees go to their breaks on time and at a timely hour
Cover breaks for other employees Maintain a clean and organized area When opening , ensure everything is stocked and in place
When closing, make sure everything is detailed , restocked , portioned , and ready for the next day
Customer Service Representative
CalOptima
02.2019 - 03.2021
Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Streamlined call center processes for improved efficiency and reduced wait times.
Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Assisted customers in navigating company website and placing online orders, improving overall user experience.
Answer inbound phone calls
Assist members with eligibility information
Assist members general Medi-Cal eligibility information
Confirm members general information including name, address , phone number
Assist with proving correct information on member’s pending authorization Assist with searching , selecting, and assigning member’s PCP
Assist with transferring members correctly and providing the phone number to Medi-Cal Dental phone number , SSA , or others when contacting the incorrect one
Assist members with filing grievances when needed and providing the correct information on the process of a grievance.
Keep an organized computer and desktop area in order to ensure most efficient work is completed.
Maintain a well organized timeline on managing call backs when needed on top of other projects
Education
High School Diploma -
Santa Ana College
Santa Ana, CA
2019
Skills
Interpersonal Skills
Cross-Cultural Sensitivity
Disability Awareness
Time Management
Multitasking
Attention to Detail
Medicaid Knowledge
Customer Service
Microsoft Office
Policy Knowledge
Program Knowledge
Telephone Etiquette
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Eligibility Technician
Social Services Agency
10.2023 - Current
Cashier 3
The Habit
08.2022 - 09.2023
Customer Service Representative
CalOptima
02.2019 - 03.2021
High School Diploma -
Santa Ana College
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