Jennifer Sanchez
El Paso,USA
Summary
Highly motivated and hard-working professional with over 10 years of experience in data entry and customer service. Seeking a challenging role to further enhance skills and embrace new opportunities. Thrives in both team environments and individual projects, demonstrating self-motivation and a strong ability to collaborate effectively.
Overview
22
22
years of professional experience
Work History
Configuration Analyst
El Paso Health
03.2024 - Current
- I am responsible for the configuration of loading and updated provider records, benefits, contracts, and fee schedules for Texas Medicaid, Medicare and Preferred Administrators Health Insurance
- I ensure that the data is updated accordingly to ensure that claims are processed accurately via our QNXT application
Grievance & Appeals Coordinator II
Superior Health Plan
12.2013 - 01.2024
- I am responsible for reviewing complaints for both members and providers
- I assist in helping resolve complaints on an Internal and State level
- I provide in writing a formal response to either party in helping them resolve their complaint and providing the correct actions needed in order to resolve
- The complaints range from balance billing, claims related issues, credentialing, or quality of service
Customer Care Professional (Outbound)/Member Bill Liaison
Superior Health Plan
12.2013 - 01.2024
- I am responsible for assisting members with any member bill complaints; I contact the providers to verify if insurance information is missing, to determine if they have a legitimate claim on billing member directly, or if they are not following TMHP or Superior Health Plan policies then I educate them, so member does not get direct billed
- I also assist with making outbound calls to our members to verify information, advise them of exams they are missing and to assist with making appointments
- I also reach out to providers to update their information; assist with any issues they have regarding claims and attempt to see if they would be interested in accepting new products Superior has to offer
- I work off of spreadsheets to record my progress of work completed and pending; and also use databases to make necessary changes for providers or to look up information in respect to claims, affiliations, and participating providers
Patient Access Representative
Conifer Health Solutions
07.2011 - 11.2014
- I am responsible for registering patients who come in through the Emergency Rooms
- I ensure that their information is entered correctly into our system and crossed over to Med Host where the triage nurse can then call upon the patient
- I also obtain the patient's demographic information, insurance, emergency contacts and other information pertinent to the account once the patient has been triaged and seen by the ER doctor
- Based on the insurance information provided by the patient I also collect copayments for the ER visit or for previous visits to the hospital
- If needed I also register patients who come in through the ER for outpatient procedures and if required collect any deductibles or copayments not covered by their insurance
Customer Response Representative
State Farm
02.2011 - 07.2011
- I am responsible for filing Auto and Fire claims and providing information about process of the claims
- I also take payments over the phone for auto, fire, and life policies
- When requested I will also forward messages to client's Agent notifying them of any changes that need to be made
Senior Client Service Representative
ADP
05.2006 - 04.2009
- I was responsible for assisting our small business clients in processing payroll over the phone, via fax, or via Easy Pay Net
- I also helped setup garnishments for our client's employees
- I provided information to clients in regard to their tax deposits and filings as well as inform them on what is needed so they meet all requirements with the IRS and SSA
- I was also part of the Resolution Team which entailed processing Amendments, Exceptions, Bank Account Changes, etc
Client Service Representative
Comdata
05.2005 - 05.2006
- I was responsible for taking inbound calls from truck drivers and gas station clerks to verify comdata codes with monetary value onto comchecks
- I would have to verify the validity of those comdata codes and ensure with security information listed that the correct person was calling in to redeem the codes and that the funds were available for cashing out or purchasing gasoline
Telemarketer
Redcats USA
05.2004 - 03.2005
- I was responsible for taking orders over the phone from catalogs; I would also sell additional items from those catalogs as well as from other companies associated with Redcats
Customer Service Representative
SBC
05.2003 - 01.2004
- I was responsible for placing orders for new phone service, transferring phone service for existing customers, or making changes to current phone service upon customers' request
- I would also assist with billing inquiries, internet sales and installation dates
Customer Service Representative
Affina
03.2003 - 05.2003
- I was responsible for placing customer orders, informing customers with prices on product parts or filters for brand names such as Holmes, Rival, Bonaire, etc
Education
Nursing Program -
EPCC
04.2025
Bachelors Degree - Biology for Pre-Med
UTEP
04.2025
CNA -
Emerald Nursing School
03.2004
Diploma -
Jefferson High School
05.1999
Skills
- Fluent in English and Spanish
- Proficient in Computer Applications
- Analytical Problem Solving
- Strategic Issue Identification
- Organized Task Management
- Client Relations
- Responsive to New Challenges
- Certified Nursing Assistant Training
- Basic Life Support Certified
Languages
Spanish
Professional Working
Timeline
Configuration Analyst
El Paso Health
03.2024 - Current
Grievance & Appeals Coordinator II
Superior Health Plan
12.2013 - 01.2024
Customer Care Professional (Outbound)/Member Bill Liaison
Superior Health Plan
12.2013 - 01.2024
Patient Access Representative
Conifer Health Solutions
07.2011 - 11.2014
Customer Response Representative
State Farm
02.2011 - 07.2011
Senior Client Service Representative
ADP
05.2006 - 04.2009
Client Service Representative
Comdata
05.2005 - 05.2006
Telemarketer
Redcats USA
05.2004 - 03.2005
Customer Service Representative
SBC
05.2003 - 01.2004
Customer Service Representative
Affina
03.2003 - 05.2003
Bachelors Degree - Biology for Pre-Med
UTEP
CNA -
Emerald Nursing School
Diploma -
Jefferson High School
Nursing Program -
EPCC
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