Joann Vizcaino
San Antonio,TX
Summary
Analytical, vivacious, and meticulous customer service advocate IV with extensive and profound knowledge of business metrics, trends, and leadership, including the creation of medical claims, different Medicare & Medicaid (CMS) payment methods, and comprehension of the phrasing of billing regulations and processes.
Overview
8
8
years of professional experience
Work History
Escalation Response Specialist IV
Centene
San Antonio, TX
10.2019 - Current
- In my role as a team leader, I prioritize ensuring that each team member comprehends their specific responsibilities related to problem-solving, de-escalation, and the application of soft skills during customer interactions. I provide coaching aimed at fostering their ability to educate clients and actively listen to identify areas for improvement. Additionally, I have developed and implemented training programs focused on understanding processed claims in accordance with Medicare and Medicaid (CMS) guidelines, with sessions conducted for all Customer Service Agents (CSAs) in July 2023 and April 2024.
- I utilize Excel formulas and spreadsheets to analyze data and generate statistics that inform the construction of data models. My technical proficiency extends to Microsoft Office on both Windows 10 and 11, as well as tools such as Power BI, Qualtrics, SQL, and MicroStrategy. I am committed to evaluating and maintaining project reports promptly, assessing my team members' needs in claims processing to produce business-approved documentation, and creating workflow diagrams and process models that align with organizational requirements.
- I collaborate closely with the Business Analyst Department on various projects aimed at tracking Medicare trends using platforms like OMNI, SuccessKPI, Power BI, Qualtrics, and Ember. A significant achievement includes the development of an escalations ticket system for the previously named Ascension Joint Venture utilizing the Ember system. Furthermore, I possess a strong understanding of corporate policies and procedures within the CMS call center and excel at organizing performance data for agents, which aids my supervisor in determining the appropriate next steps for submitting HR tickets.
- As of this year, I quickly adapted to new responsibilities as an ESR lead by adjusting claims, understanding workflows, and I went above and beyond to support our claims department with adjusting claims outside of my current role.
- Working closely with our department business analyst to make significant updates to our work processes, ensuring that our PET remains up to date with the highest quality standards and enabling our team to handle calls more efficiently.
- Collaborating with Quality has deepened my understanding of the quality aspects when it came to providing the provider with experience with claim processing. It has also underscored the importance of ensuring that our agents comply with these standards, especially as this new role was unfamiliar to quality. Our mutual support has been invaluable in navigating the intricacies of claims processing methods to ensure compliance is being followed along with providing a positive provider experience.
Health Coach
Leading Edge Personnel
San Antonio, TX
08.2018 - 09.2018
- I assisted patients with diabetes, hypertension, and hyperglycemia, improved their general health by sharing nutrition information and fitness tips, monitored their progress against pre-determined health targets, educated them on various medication options to prevent missed dosages, and provided 90-day supplies, automatic services, and Rx messaging, all while staying knowledgeable about policies and procedures in line with changes in local, state, and federal laws and regulations.
Pharmacy Benefits Manager
CVS Health Corp.
San Antonio, TX
11.2017 - 05.2018
- Acquainted with HIPAA, OSHA, and PHI, as well as federal and state laws pertaining to medication dispensing; able to explain to patients the benefits of the plan, including coverage of medication tiers, deductibles, Prior Authorizations, Social Security programs, and override availability; proficient in medication tiers such as brand, generic, preferred brands and generic, combination, and specialty; able to process insurance claims for insurance companies; able to calculate quantities for various medications (insulin, nasal sprays, tablets, etc.); helping other pharmacy technicians/pharmacists with medication orders and system coding; providing reasonable discounts and promotions in order to maintain a high customer retention rate; promoted as a manager for de-escalating complaint calls; and improving customer satisfaction ratings by overseeing all client inquiries through resolution.
Education
B.A. - Business Management
Texas A&M University
College Station/San Antonio, TX12.2021
A.A. - Public Admin.
Alamo Colleges
San Antonio, TX05.2018
Certified Medical Assistant (MA) - undefined
Concorde Career College
06.2015
High School Diploma & Certified Public Relations - undefined
Travis Early College High School
San Antonio, TX06.2014
Skills
- Mathematical aptitude
- Proficiency in Microsoft Office
- Planning and organizational skills
- Effective Communication
- Articulate in writing
- Reading Workflows
- MicroStrategy
INTERESTS
Reading, Music, Art, T.V. Shows/Movies, Outdoor Activities, Travel
Timeline
Escalation Response Specialist IV
Centene
10.2019 - Current
Health Coach
Leading Edge Personnel
08.2018 - 09.2018
Pharmacy Benefits Manager
CVS Health Corp.
11.2017 - 05.2018
A.A. - Public Admin.
Alamo Colleges
Certified Medical Assistant (MA) - undefined
Concorde Career College
High School Diploma & Certified Public Relations - undefined
Travis Early College High School
B.A. - Business Management
Texas A&M University