Itzel Pena

As a customer care advisor I completed the following tasks :

• Logged incoming call information and solutions provided into internal database.
• Addressed customer complaints and mitigated dissatisfaction by employing timely and on-point solutions.
• Responded to customer needs through competent customer service and prompt problem-solving.
• Navigated multiple computer systems and applications to find information.
• Cross-trained and provided backup support for organizational leadership.
• Assembled products according to changing daily work orders and specific customer needs.
• Received and reviewed incoming documents and materials.
• Maintain strict confidentiality of applicant information in accordance with company and legal standards
• Review and verify incoming applications for completeness and accuracy, ensuring all necessary documentation is included.
• Communicate with applicants to obtain missing information or clarify discrepancies in submitted documents.
• Enter and update application data in the system, maintaining a high level of accuracy.
• Coordinate with other departments to resolve any issues or inconsistencies in applications.
• Track and monitor the status of applications, providing updates to applicants as needed.

• Met customer call guidelines for service levels, handle time and productivity.
• Responded to customer requests for products, services, and company information.
• Documented and detailed calls and complaints using call center's CRM database.
• Adhered to company policies and scripts to consistently achieve call-time and quality standards.
• Placed outbound customer service or customer satisfaction calls to follow up on issues.

• Establish or maintain patient profiles, including list of medications taken by individual patients
• Obtain customer information such as name, address, date of birth and ensuring that information is correct
• Prepare and process medical insurance claim forms and record
• Supported doctors and hospitals in obtaining prior authorizations
• Provide excellent customer service to callers.
• Consulted with insurance company representatives to complete claims processing, resolve concerns, and reconcile payments.
• Tracked referral submission during facilitation of prior authorization issuance.
• Verified eligibility and compliance with authorization requirements for service providers.
• Prepared and distributed denial letters, detailing reasons for denial and possible appeal measures.
• Developed and maintained productive working relationships with healthcare providers.
• Evaluated clinical criteria for approval or denial of services requiring pre-authorization.

• Effectively resolved insurance rejections and other billing issues
• Assisted other pharmacy staff with drug inventory, purchasing, and receiving
• Performed technical processes required to dispense medications to patients
• Hand counted control medications, measured liquids and reconstituted antibiotics
• Accurately and efficiently preparing prescription orders
• Entering patient and order information into the pharmacy system
• Processing and submitting insurance claims
• Providing quality customer service to patients and other healthcare providers in person and via phone as well.

• Handle cash, credit or check transactions with customers
• Scan goods and collect payments
• Issue change, receipts, refunds, or tickets
• Redeem stamps and coupons
• Count money in cash drawers at the beginning and end of shifts to ensure that amounts are correct and that there is adequate change
• Resolve customer complaints, guide them and provide relevant information
• Greet customers when entering or leaving establishment
• Maintain clean and tidy checkout areas
• Keep reports of transactions
• Process returns and check to see if items are damaged
• Pleasantly deal with customers to ensure satisfaction.