JENNIFER GALLEGOS
Albuquerque,NM
Summary
Client-focused Sales Representative and Business Leader with 12+ years of providing solutions to customers. Solid understanding of the business building rapport associated with customer centered service and experience.
Overview
18
18
years of professional experience
Work History
Claims Examiner
Blue Cross Blue Shield
03.2019 - Current
- This position is responsible for processing complex claims requiring further investigation, including coordination of benefits and resolving pended claims
- Data entry and typing experience
- Clear and concise written and verbal communication skills
- Knowledge of medical terminology and CPT, HCPCS, and ICD9 coding
- Knowledge of coordination of benefits principles and terminology
- Experience with multitasking and prioritizing
- PC proficiency to include Microsoft Word, Excel, Outlook
- Conduct research and investigation into missing information, make phone calls to providers
- Access resource materials and support files in order to process and adjudicate claims timely and accurately
- Ability to multitask, prioritize and work in a high production environment
- Review and understand Explanation of Benefits to coordinate with other insurance information.
Network Marketing & Direct Sales
Race to Wellness-Self Employed
10.2012 - Current
- Created and executed marketing/PR campaigns, including new product introductions and existing product development
- Worked closely with company executives to identify new business opportunities and routinely participated in the sales process
- Communicated with customers, employees and other individuals to answer questions and explain information
- Generated new accounts by implementing effective networking and content marketing strategies
- Optimized current revenue streams by networking for additional business prospects with established clients
- Planned strategic brand building events to expand the product portfolio
- Contacted new and existing customers to discuss how specific products could meet their needs
- Identified, coordinated and participated in client relationship-building activities and meetings
- Coached and mentored numerous team members by offering constructive feedback and taking interest in their long-term career growth.
Social Worker-Highschool
Cuba Independent School District
05.2024 - 07.2024
- Social worker responsible for meeting with highschool students and families both on and off of school grounds to ensure academic success, mental and physical wellbeing, course planning for education beyond high school, provide therapeutic sessions and interventions when appropriate
- Work closely with therapists, teachers, family and school to develop a path for success utilizing available resources and catering to special needs.
Behavior Management Specialist
Cuba Independent Schools
11.2022 - 12.2022
- This was a brief role filled at the Cuba Elementary School responsible for modeling positive behavior for children ages PreK to 6th grade
- Required familiarity with student treatment plans, IEP's, 504 plans
- Behavior management intervention in classroom and within campus grounds, assist teachers in reinforcing positive classroom behavior and basic skills, reading and writing, aid in delivery of assignments, tutoring sessions, and testing for academic placement and skill set monitoring.
Advocate 4 ME
United Healthcare
01.2017 - 09.2019
- Simplify health care system guidance and drive engagement in programs across the continuum of care
- Perform closed, denied, and simple claim adjustments
- Meet quality and customer satisfaction requirements
- Maintain accurate documentation in ORS
- Take accountability and ownership for any follow - up work needed to resolve and close issues
- Take ownership of resolution inquiries end to end
- Resolve issues including benefits, eligibility and claims as needed
- Pitch clinical programs in individual/group settings as appropriate
- Identify and resolve anticipated member issues to prevent future calls
- Maintain proficiency in all technical applications (technical skills and system knowledge)
- Comply with all current policies, procedures and workflows
- Work independently and with others
- Acts as a resource for others.
Technical Support-Tier 3
T Mobile
05.2010 - 03.2011
- Performed extensive troubleshooting on product and service issues to resolve customer concerns with one-call resolution
- Supported customers having data/network/device connectivity issues
- Worked hand-in-hand with the company engineering team filing trouble tickets and queries to achieve network resolution
- Exhibited exemplary de-escalation skills to resolve customer concerns using strong verbal and negotiation techniques
- Displayed courtesy and rapport building interpersonal skills in all customer interactions
- Maintained composure and patience in the face of challenging customer situations
- Researched issues on various computer systems and databases to address and answer inquiries
- Referred stagnant issues to upper management while maintaining positive communication with customers
- Informed and educated customers about issue resolution, progress, timelines and updated communications
- Expertise with Windows, iOS and Android operating systems.
Senior Business Svc Center Representative/Senior Cust Svc Representative/Technical Support-Tier 1
Verizon Wireless
09.2006 - 11.2008
- Delivered an exceptional customer service experience during both inbound/outbound call interactions as well as face-to-face in retail store opportunities
- Collected client feedback for commercial and business end services to exceed customer satisfaction goals while supporting business growth and needs
- Made reasonable procedure adjustments to accommodate unusual customer requests while prioritizing company procedures and policies
- Provided accurate and appropriate information in response to customer inquiries
- Demonstrated mastery of customer service flow within specified time frames while addressing customer service inquiries in a timely and accurate fashion
- Maintained up-to-date records at all times
- Developed effective relationships with all call center/retail store departments through clear communication
- Ran reports and supplied data to fulfill customer report requirements
- Worked with upper management to ensure appropriate changes were made to improve customer satisfaction while elevating company revenue
- Built customer loyalty by placing follow-up calls for customers who reported product and/or billing issues, in addition, educating customers on promotions and better fit plans available to them
- Formulated and enforced Service Center policies, procedures and quality assurance measures to lead a specialized customer service team called STAR
- Trained staff on how to improve customer interactions and loyalty
- Properly directed inbound/outbound calls in phone queues to improve call flow and customer experience
- Performed tier 1 troubleshooting on all devices before escalating to next level of support
- Exceeded company standards in the sale of accessories, devices and higher level plans to eligible commercial and business end clients
- Assisted in training new hires during transition from classroom to production floor
- Consistently met and exceeded company goals for expected performance and measured stats on all ends of performance
- Regularly provided supervisor support to implement team competition, credit adjustments, quality assurance monitors and company wide communications.
Education
Bachelor of Science - Counseling Psychology
Santa Fe, New Mexico College of Santa Fe
Skills
- Strong networking expertise in building lasting interpersonal business relationships
- Excellent verbal and written communication skills
- Exceptional experience in customer facing sales both individually and in a group setting
- Accomplished troubleshooting proficiency and vast technical knowledge with mobile devices
- Patient problem-solver with diligent attention to detail
- Strong ability to multi-task across systems and applications
- Superior time management skills
- Consistent ability to right fit customers needs while recognizing current business trends
Accomplishments
- Organized large scale promotional events to deliver product and business information to prospective clients.
- Introduced business structure and compensation plan to potential partners via events, mobile communication, social media and client centered forums.
- Exceeded monthly goals by successfully handling customers issues the first time resulting in business wide leadership recognition for lowest rate of customer dissatisfaction.
- Reduced client escalations to management significantly by using customer focused communications and business centered emphasis on value of service and products provided while emphasizing the importance of customer value and satisfaction.
Timeline
Social Worker-Highschool
Cuba Independent School District
05.2024 - 07.2024
Behavior Management Specialist
Cuba Independent Schools
11.2022 - 12.2022
Claims Examiner
Blue Cross Blue Shield
03.2019 - Current
Advocate 4 ME
United Healthcare
01.2017 - 09.2019
Network Marketing & Direct Sales
Race to Wellness-Self Employed
10.2012 - Current
Technical Support-Tier 3
T Mobile
05.2010 - 03.2011
Senior Business Svc Center Representative/Senior Cust Svc Representative/Technical Support-Tier 1
Verizon Wireless
09.2006 - 11.2008
Bachelor of Science - Counseling Psychology
Santa Fe, New Mexico College of Santa Fe