Jeanette Castanon
San Antonio,TX
Summary
Administrative and Customer Service Professional
With over 20 years of hands-on experience in providing administrative support and training in various fields of the healthcare industry, bring extensive knowledge and expertise to every task including developing innovative techniques and strategies to enhance daily operations and contribute to the company’s success by delivering the highest level of service.
Key Strengths:
Customer Service Excellence: Proven ability to navigate challenges and deliver exceptional service.
Problem-Solving: Strong analytical skills and a proactive approach to new tasks.
Adaptability and Creativity: Known for flexibility and innovative thinking.
Results-Oriented: Committed to making meaningful contributions and advancing organizational goals.
Dedicated to leveraging skills and experience to support and enhance organizational success.
Overview
15
15
years of professional experience
Work History
Tier 1 Help Desk Agent
MMC / CGI Federal
05.2024 - 08.2024
- Used ticketing systems to manage and process support actions and requests.
- Provided Tier 1 IT support to non-technical internal users through desk side support services.
- Compiled and accurately entered data for each customer encounter to record in system.
- Resolved escalated issues by serving as subject matter expert on wide-ranging issues.
- Provided basic end-user troubleshooting and desktop support.
- Documented support interactions for future reference.
- Maintained detailed records of customer interactions, documenting resolutions for future reference.
- Enhanced customer satisfaction by efficiently resolving technical issues and providing timely solutions.
- Acted as liaison between end-users and higher-level support teams, ensuring seamless handoff when needed for more advanced problem solving.
- Implemented effective escalation procedures, directing complex issues to appropriate personnel for resolution.
Training Manager / Customer Service Representative / Collections
Alorica
08.2021 - 02.2024
- Responsible for conducting orientation programs for a class of 20 to 30 new hires. Arranging on-the-job training for new hires and developing learning and developmental strategies in which assess the skills, performance, productivity, and talents of employees
- Prepared written evaluations with advice for improvement
- Identified future training needs and created A curriculum to facilitate training
- Lead programs to assist employees with transitions due to technological changes, acquisitions, and mergers
- Communicated with management, trainers, and team members to ensure that all needs are met
- Resolved any specific problems and tailored training programs, as necessary.
Claims Specialist
Allstate Insurance
04.2018 - 04.2019
- Enhanced customer satisfaction with timely communication, empathy, and clear explanations of claim outcomes.
- Managed high volume of claims effectively by prioritizing tasks and maintaining excellent organizational skills.
- Developed strong working relationships with external partners such as adjusters, legal counsel, and medical professionals to facilitate efficient claim resolution processes.
- Achieved performance targets consistently through attention to detail, effective time management, and strong decision-making abilities.
Customer Service Representative II
Centene Corporation
08.2017 - 04.2018
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Resolved customer conflict by identifying the issue and finding the best practical option or solution
- Assisted members with inquiries on benefits, eligibility, claims, billing, and payments by researching claims issue and appropriately escalated as necessary, ensure correct benefits were being applied by researching and correcting any incorrect payments, gathered any missing information
- Served liaison by organizing, communicating, coordinating, between all entities to achieve best utilization of resources
- Clarified any concerns or questions about explanation of benefits (EOB), flexible spending accounts and correspondences
- Used probing questions while listening actively and documenting required information, referencing CMS/ Medicare benefits plan documents
- Intervene with care providers (doctors’ offices) on behalf of customer to assist with appointment scheduling, transportation arrangements, and any other tasks necessary to ensure highest level of service care
- Escalated all grievances to appropriate branch
- Appropriate closing response
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Resolved escalated customer issues, restoring confidence in company's commitment to service excellence.
Benefits Advocate / Claims Specialist
United Healthcare PPO Commercial
06.2015 - 07.2017
- Managed and responded to 80 to 100 inbound and outbound calls by answering and resolving any issues questions concerns
- Improved the lives of members promoting wellness programs as A preventive measure to prevent illness, control, and manage conditions or disease
- Answered questions, and resolve issues regarding health care eligibility, claims and payments, eligibility, explanation of benefit's precertification, authorizations referrals, correspondences and or financial spending accounts by researching all plan documents ensuring proper benefits are being applied, gathering any missing information, correcting any errors
- Communicating and intervening with primary care physicians on behalf of members
- Reviewing, researching, and processing healthcare claims
- Adjusted claims as needed, corrected any incorrect payments
- Research complex issues across multiple databases and support resources refer unresolved customer grievances to designated departments for further investigation
- Accurately entered all documentation with great attention to detail eliminating any errors, provided worked independently and manage one's time efficiently ensuring all deadlines and timely filing were met.
- Established trusting relationships with clients by maintaining open lines of communication throughout the entire representation process.
Office Coordinator
Christus Santa Rosa Children's Hospital Of San Antonio Specialty Clinic
10.2009 - 02.2014
- Facilitated all referrals and authorizations for medical services rendered
- Registered all new patients into the system
- Check in and outpatient
- Insured all appropriate forms were completed
- Obtained patient demographic and insurance information
- Collected copays, deductibles, copays, and any out-of-pocket fees at time of patient visit
- Managed physician and clinician schedules, appointments, and correspondences for 80 patients
- Provided front desk support, greeted patients in A courteous and professional manner, provided information as asked, explained all financial aspects to patients
- Respond to requests for information and referrals from parents and other professionals
- Complete all tasks in A timely manner
- Obtained required documentation and reports
- Gather appropriate documentation including insurance verification, authorizations, and pre certifications
- Keep patient informed on status of referral
- Work collaboratively in A team environment
- Maintain confidentiality
- Performed other job duties as assigned, answered phones, followed up with patients, confirmed appointments, and maintained medical records.
Front Office Manager
San Antonio Clinical Genetics
10.2009 - 02.2014
- Managed office productivity, coordinated referrals from other physician offices or specialists, coordinated all genetic testing by initiated authorizations of specific laboratory and diagnostic testing
- Managed physician schedule, appointments, and correspondence maintained patient medical records
- Greeted patients and visitors in A courteous and professional manner
- Collected copays, deductibles and coinsurance, answer telephone and respond to inquiries, responsible for patient scheduling, verified insurance benefits for patient, conducted reminder calls to all patients, reviewed patient charts to make sure all information was up to date, reviewed and processed explanation of benefits
- Entered all fee tickets in to billing system
- Ensure accuracy of claims and billing fees.
Education
Associates Of Applied Science - Medical Administration
10.2010
Skills
- Customer Service and Support: Proficient in using Zendesk Oracle Right now Confluence, I&A, IDM, NPPES, PECOS Live Agent live vox, for managing customer interactions and support tickets
- IT Service Management: Experienced with ServiceNow for IT service management and workflow automation
- Cloud Platforms: Skilled in Amazon Web Services (AWS) and Oracle Cloud Infrastructure for cloud computing and data management
- Healthcare Software: Extensive experience with Athena health, NextGen, Epic, Kareo Customer Service and Support: Proficient in using Zendesk, Live Vox, and Live Agent for managing customer interactions and support tickets
- IT Service Management: Experienced with ServiceNow for IT service management and workflow automation
- Cloud Platforms: Skilled in Amazon Web Services (AWS) and Oracle Cloud Infrastructure for cloud computing and data management
- Healthcare Software: Extensive experience with Athenahealth, NextGen, Epic, Kareo, PRACTICE FUSION and Healow for electronic health records (EHR) centricity and practice management
- Communication Tools: Familiar with Slack for team collaboration and Grasshopper for business phone systems
- Identity and Access Management: Knowledgeable in implementing and managing identity and access management systems
- API Integration: Experienced in integrating various software solutions using APIo, PRACTICE FUSION and Healow for electronic health records (EHR) centricity and practice management
- Communication Tools: Familiar with Slack for team collaboration and Grasshopper for business phone systems
- Identity and Access Management: Knowledgeable in implementing and managing identity and access management systems
- API Integration: Experienced in integrating various software solutions using API
- Empathy and patience
- Training and mentoring
- Ticketing system expertise
- Remote Support
- Desktop support
- Ticket management
- Product Troubleshooting
- Appointment Scheduling
- Microsoft Outlook
- Complaint resolution
- Call Center Operations
- Customer Success Management
- Performance Testing
- Microsoft Office Specialist (MOS) Expert
- Staff education and training
- Problem-Solving
- Teamwork and Collaboration
- Time Management
- Attention to Detail
- Multitasking Abilities
- Excellent Communication
- Organizational Skills
- Active Listening
- Effective Communication
Keyjobskills
- Customer service outbound and inbound
- Billing and coding claims processing
- Front office management
- Benefits advocate
- Intake coordinator
- Admissions
- Authorizations specialist
- Referral coordinator
- Office coordinator
Personal Information
Title: Medical Administrative Assistant
Personal Qualifications
Problem analysis problem solving critical thinking adaptability – ability to work under pressure. People oriented ability to establish and maintain client relations. Strong work ethics, positive attitude, active listening, empathetic ensure effective clear. Language and understanding management organize and. Prioritize initiator- utilizes strategic tactics to target specific milestones to achieve overall goal dedicated- to the needs of the consumer and company excellent communication skills- negotiation
Timeline
Tier 1 Help Desk Agent - MMC / CGI Federal
05.2024 - 08.2024
Training Manager / Customer Service Representative / Collections - Alorica
08.2021 - 02.2024
Claims Specialist - Allstate Insurance
04.2018 - 04.2019
Customer Service Representative II - Centene Corporation
08.2017 - 04.2018
Benefits Advocate / Claims Specialist - United Healthcare PPO Commercial
06.2015 - 07.2017
Office Coordinator - Christus Santa Rosa Children's Hospital Of San Antonio Specialty Clinic
10.2009 - 02.2014
Front Office Manager - San Antonio Clinical Genetics
10.2009 - 02.2014
Career Point College - Associates Of Applied Science, Medical Administration
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