Overview
Summary
Work History
Education
Skills
Timeline
Generic

Jessica Gonzales

Long Beach,CA

Overview

11
11
years of professional experience

Summary

Dynamic Call Center Representative with Healthcare, skilled in bilingual communication and customer service. Achieved performance goals while fostering positive relationships and effectively managing conflict. Proficient in scheduling and record keeping, contributing to improved member engagement and compliance with healthcare standards. Committed to enhancing service delivery and member satisfaction.

Work History

Patient Care Coordinator

UnitedHealth Group
05.2022 - Current
  • Managed sensitive patient information with strict adherence to HIPAA guidelines, maintaining confidentiality and privacy at all times.
  • Provided exceptional customer service by addressing concerns, answering questions, and ensuring patient satisfaction with their care experience at the clinic.
  • Enhanced patient satisfaction by efficiently scheduling appointments and managing patient flow.
  • Streamlined communication between patients and healthcare providers, ensuring timely responses to inquiries and concerns.
  • Communicated with insurance companies to verify coverage and obtain authorizations for medical treatments and procedures.
  • Delivered excellent patient experiences and direct care.
  • Coordinated with insurance companies for accurate billing and claim processing, reducing errors and financial discrepancies.
  • Fostered strong relationships with referral sources for increased network connections, benefiting both the clinic and its patients through expanded resources.
  • Reduced wait times by implementing an effective appointment reminder system for patients, minimizing no-shows and late arrivals.
  • Monitored inventory levels of medical supplies and equipment, placing orders when necessary to prevent shortages or delays in patient care provision.
  • Implemented a more efficient system for managing medical records, resulting in faster access to crucial information during patient visits.
  • Provided compassionate support for families during difficult healthcare decisions, acting as a liaison between them and their loved ones'' medical team.
  • Streamlined patient admission processes, reducing wait times and improving overall efficiency.
  • Coordinated discharge planning, ensuring smooth transitions to home care or rehabilitation facilities.

Appeals and Grievances Coordinator

Cigna Healthcare
11.2021 - 10.2022
  • Processed and finalized appeals and grievances within agreed-upon turnaround time.
  • Remained knowledgeable regarding company policies and procedures and current developments within operational departments.
  • Submitted verbal and written notification to members and providers.
  • Entered appeal requests in appeals module.
  • Expedited resolution times by proactively communicating with members, providers, and other stakeholders throughout the grievance process.
  • Served as a key resource for colleagues seeking guidance on case-specific issues or regulatory requirements, fostering a cooperative team environment.
  • Provided outreach for additional information for appeals and grievances.
  • Enhanced internal processes for handling complaints by developing standardized guidelines and documentation templates.

CSR

Anthem Healthcare
11.2018 - 07.2019
  • Managed high call volumes, maintaining a professional demeanor during peak hours and effectively multitasking in a fast-paced environment.
  • Demonstrated empathy and active listening skills, resulting in a higher rate of customer satisfaction and repeat business.
  • Answered customer telephone calls promptly to avoid on-hold wait times.
  • Answered constant flow of customer calls with minimal wait times.
  • Responded to customer requests for products, services, and company information.
  • Developed strong relationships with clients by understanding their needs and preferences, fostering long-term loyalty.
  • Enhanced customer satisfaction by promptly addressing inquiries and resolving issues efficiently.
  • Upheld strict adherence to company policies and procedures while providing exceptional service experiences for each client interaction.
  • Assisted customers with account set-up, enabling smooth transitions into using the company''s products or services.
  • Streamlined communication between departments, ensuring timely resolution of customer concerns.
  • Improved customer retention rates with exceptional product knowledge and personalized service recommendations.
  • Served as a liaison between internal teams and customers during critical situations, facilitating open communication channels for swift issue resolution.
  • Provided comprehensive training for new team members, resulting in faster onboarding and better overall performance.

Call Center Representative

Molina Healthcare
09.2016 - 10.2018
  • Managed high call volumes while providing exceptional customer support and maintaining professional composure.
  • Enhanced customer satisfaction by efficiently addressing and resolving inquiries in a timely manner.
  • Reduced average call handling time, ensuring prompt service to customers while maintaining quality interactions.
  • Developed rapport with customers through empathetic listening skills, creating positive experiences even during difficult conversations.
  • Maintained detailed records of customer interactions, streamlining communication efforts between various departments.

Food Cashier

Hole Mole
01.2016 - 03.2017
  • Resolved customer complaints independently or with aid of supervisor.
  • Operated and sanitized kitchen and food preparation equipment.
  • Enhanced customer satisfaction by efficiently processing transactions and addressing inquiries.
  • Maintained a clean and organized workspace, contributing to a positive customer experience.
  • Suggested and described items based on guest preferences.
  • Demonstrated flexibility in covering shifts as needed, contributing to overall team efficiency.
  • Handled customer complaints professionally, resolving issues promptly and courteously.
  • Reduced wait times for customers by expediting orders using effective communication skills with the kitchen staff.
  • Operated cash register to process sales transactions, handle cash and make change.
  • Entered food and beverage orders into POS system.
  • Engaged customers to help create superior food and beverage experience.
  • Replaced CO2 tanks and soda syrups when depleted.
  • Worked with floor team and managers to meet wide range of customer needs.

Retail Cashier

St Vincent De Paul Society Thrift Stores
07.2014 - 12.2014
  • Helped customers complete purchases, locate items, and join reward programs.
  • Provided excellent service through active listening skills, addressing customers'' needs effectively .
  • Maintained a clean and organized workspace, promoting a positive shopping experience for customers.
  • Greeted all customers warmly to build welcoming and positive atmosphere within store.
  • Cultivated a welcoming retail environment by greeting customers warmly upon entry, setting a friendly tone throughout their visit .
  • Replenished sales floor merchandise and organized shelves, racks, and bins for optimal appearance.
  • Resolved customer complaints promptly and professionally, fostering a positive reputation for the store.
  • Processed credit, debit card and cash transactions correctly and provided accurate change to avoid customer confusion or disputes.
  • Trained new employees on company policies, register operations, and effective communication techniques with customers.
  • Enhanced customer satisfaction by providing efficient and accurate cash handling services.
  • Balanced cash drawer at the end of each shift, ensuring accuracy and accountability.

Education

GED -

Willow Adult School
Long Beach, CA

Skills

  • Critical thinking skills
  • HIPAA compliance
  • Organizational skills
  • Appointment scheduling
  • Customer service
  • Patient relations
  • Attention to detail
  • Insurance verification
  • Patient care coordination
  • Patient care
  • Patient confidentiality
  • Verbal and written communication
  • Scheduling
  • Medical terminology
  • Patient education
  • Patient records management
  • Goal setting
  • Patient documentation
  • Follow-up care
  • Documentation
  • Patient safety
  • Patient registration
  • Filing and recordkeeping
  • Proficient in software
  • Office administration
  • Relationship building
  • Payment collection
  • Care planning
  • Policy compliance
  • Insurance practices
  • Healthcare operations
  • Patient assessment

Timeline

Patient Care Coordinator

UnitedHealth Group
05.2022 - Current

Appeals and Grievances Coordinator

Cigna Healthcare
11.2021 - 10.2022

CSR

Anthem Healthcare
11.2018 - 07.2019

Call Center Representative

Molina Healthcare
09.2016 - 10.2018

Food Cashier

Hole Mole
01.2016 - 03.2017

Retail Cashier

St Vincent De Paul Society Thrift Stores
07.2014 - 12.2014

GED -

Willow Adult School

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Jessica Gonzales