Janette Contreras
Maricopa,AZ
Summary
Experienced with managing customer interactions and providing effective solutions. Utilizing communication and problem-solving skills to address customer concerns promptly. Knowledge of fostering positive customer relationships and maintaining high service standards.
Overview
22
22
years of professional experience
Work History
Customer Service Representative
State of Arizona
Phoenix, Arizona
10.2022 - Current
- Conducted comprehensive analysis of reports from public and private entities regarding allegations of abuse,neglect or exploitation.
- Answered incoming calls and respond to inquiries in a caring and professional manner.
- Triage reports for urgency of needs to coordinate to the investigation queue.
- Streamlined calls for reports to be handled to reduce the wait time for the callers.
- Mentored new staff in processes that include Safe Alerts and sending notifications to reporting parties.
Patient Access Representative
Banner Health
Phoenix, Arizona
02.2022 - 07.2022
- Complete registrations of patients arriving by ambulance or by own personal vehicle.
- Collected patient copayments and or coinsurance due at time of service in the ED.
- Apply patients for AHCCCS medicaid and or other finance programs offered by the hospital.
- Trained staff in how to use the new collecting method Curae for possible collection of service.
- Worked with health plans , nurses, and doctors to established amounts billed by payor.
- Completed Estimates on every single account and used Equifax health.
Unit Supervisor
AHCCCS
Phoenix, Arizona
05.2021 - 02.2022
- Supervise call center agents to achieve productivity, timeliness under state and federal guidelines.
- Intake inbound escalated calls from agents needing assistance in changing health plans.
- Inbound calls to change health plans within certain geographical areas.
- Complete reports to analyze dropped calls and or improvement processes.
- Worked with health plans to establish correct recipients enrolled in the correct healthplan by county.
- Completed unit projects to include the new AHCCCS system to take incoming calls Genysys.
Pharmacy Service Associate
Cigna
Phoenix, Arizona
07.2019 - 03.2021
- To complete prior authorizations on specialty medication dispensed in a doctor, pharmacy or facility setting
- Facilitate policy and procedures on medications to obtain paid claims
- Monitored ongoing authorization requests, collaborating with healthcare providers to expedite patient care.**
- Approve frontline medication and process notifications for prescriber and member within state specific timeframe
- Determine in intensive detail what product can be alternative used for the medication being requested
- Take incoming calls to process prior authorizations within an average handle time to achieve department goals
- Complete incoming faxes and online request in a timely manner for the authorization of claims
- Provided pharmacy override for providers on medications following company guidelines
Unit Supervisor
Division Benefits and Medical Eligibility
Phoenix, Arizona
11.2005 - 04.2019
- To coach and mentor employees to succeed in company production goals.
- Supervised employees to meet agency quality assurance standards by completing case reviews
- Promote positive attainable goals for direct reports to achieve completion rates
- Completed high priority cases established by the community partners within a hospital setting.
- Completed interviews for prospective candidates for opportunities within the department.
- Worked with health plans to established amounts billed/payor
- Provided pharmacy override for customers in need following company guidelines
- Established eligibility for Snap, Cash and Medical assistance programs
Child Support Officer I
State of Arizona
Phoenix, Arizona
05.2015 - 12.2015
- Register Interstate cases from other state initiating jurisdictions to collect funds.
- Review of court orders and documents to process child support requests. Maintain a record of cases to ensure federal timelines expectations
- Communicate with case managers, attorneys, and coworkers to achieve completion goals.
Phone Banker
Wells Fargo Bank N.A
Phoenix, Arizona
10.2014 - 03.2015
- Answering inbound calls to provide great customer service satisfaction. Cash account handling via computer-based program
- Referrals of products to achieve sales metrics
- Open and closed products for customer accounts achieving financial security
- Completed review of products to ensure no fraud claims in customers’ accounts
- Detailed Oriented information provided to customers
Sales Representative
Strategic Marketing Enterprises
Peoria, Arizona
03.2004 - 08.2005
- Inbound/outbound newspaper subscriptions for new customers.
- Mentored team members to obtain sales set by the company.
- Provided excellent customer service in heavy telephone call center atmosphere.
Education
Human Assistance Certificate -
Rio Salado Community College
Phoenix, Arizona01-2006
High School Diploma -
Trevor G Browne High School
Phoenix, Arizona05-2005
Skills
- Proficient in Spanish communication
- Self-motivated
- Multitasking
- Knowledge of Microsoft Office
- Caseload Managing
- ICD-10 Coding
- Knowledge of Star, Cisco, Equifax Health,First Net
- MVD,AZTECS,BG01 and DCSE systems
Timeline
Customer Service Representative
State of Arizona
10.2022 - Current
Patient Access Representative
Banner Health
02.2022 - 07.2022
Unit Supervisor
AHCCCS
05.2021 - 02.2022
Pharmacy Service Associate
Cigna
07.2019 - 03.2021
Child Support Officer I
State of Arizona
05.2015 - 12.2015
Phone Banker
Wells Fargo Bank N.A
10.2014 - 03.2015
Unit Supervisor
Division Benefits and Medical Eligibility
11.2005 - 04.2019
Sales Representative
Strategic Marketing Enterprises
03.2004 - 08.2005
Human Assistance Certificate -
Rio Salado Community College
High School Diploma -
Trevor G Browne High School