Katrina Fernandez
Redding,CA
Summary
Accomplished Customer Service Concierge Advanced Senior at Blue Shield of CA, assisting members with conflict resolution. Leveraged customer service expertise to enhance member satisfaction and resolve issues, significantly improving quality. Skilled in innovative lesson planning and effective management of supervised visitations, fostering trust and compliance.
Adept at fostering team collaboration and adapting to dynamic environments. Focused on achieving results and ensuring member satisfaction.
Developed strong skills in a fast-paced environment. Skilled at managing multiple tasks and maintaining calm and professional demeanor under pressure. Looking to transition into new field, utilizing transferable skills to contribute to an dynamic organization.
Overview
17
17
years of professional experience
Work History
Customer Service Concierge Advanced Senior
Blue Shield of CA
10.2020 - Current
- Assisting agents with escalated calls and supervisor requests to deescalate and resolve their issues.
- Providing customer care to members in navigating their healthcare.
- Contributing direct support to the member on services rendered in claims and collaborating with provider offices and medical groups to resolve the issue.
- Reviewing raw claims and ensure they are processing correctly. Develop claims and making adjustments.
- Improved service quality with attention to detail in member interactions with providers. Aid members in filing appeals.
- Assisting the Pharmacy Hub department with prescriptions inquiry, claims processing, mail order, and prior authorizations. Collaborating with provider offices and pharmacies regarding prescriptions.
- Members who suffer from chronic diseases in need of services referring them to a case manager or if an access to care connecting them to a nurse.
- Provide members with resources on health and wellness and preventive services.
- Knowledge of business software applications.
- Abide by all procedures and policies.
Triple P-Positive Parenting Program Educator
Youth and Family Programs
04.2008 - 10.2020
- Facilitate Triple P Positive Parenting Program to individuals referred by Shasta County Social Services. By conducting an overlapping sixteen-week parenting class program.
- Classes included lessons on stress management, health and wellness, communication, self-esteem, core values, and educational guidance in teaching parent's effective child-rearing positive practices.
- Provided resources to families that were involved with Child Family Services. Supported families with their goals of reunification with their children.
- Delivered quarterly reports of the parents progress to Social Workers and attended family team meetings.
- Assisted Program Manager with conducting interviews for potential employees.
- Planned events for parents and children throughout the year.
Supervised Visitations
Crown A Legacy-Founder
05.2019 - 05.2020
- Supervised Shasta County court ordered family visitations with non-custodial parents and their children.
- Provided detailed visitation reports to all parties involved, including lawyers, and Shasta County Superior Court.
- Managed scheduling for supervised visits, coordinating with multiple parties to ensure timely and efficient appointments.
- Established clear boundaries and expectations for all parties involved in the supervised visitation process.
- Developed strong rapport with families, fostering trust, and open communication during visitations.
- Provided a safe, respectful, and healthy family experience for all parties. Protected confidentiality.
Education
General Education Diploma -
Enterprise High School
Redding, CACertificate -
The University of Queensland
AustraliaSkills
- Demonstrates Emotional Intelligence
- Able to adapt to constant change
- Champions difficult goals, despite challenges
- Resolve issues directly impacting the member
- Strong research and problem-solving
- Ability to work with ethnically and culturally diverse
populations and contribute to a collaborative team environment
Timeline
Customer Service Concierge Advanced Senior
Blue Shield of CA
10.2020 - Current
Supervised Visitations
Crown A Legacy-Founder
05.2019 - 05.2020
Triple P-Positive Parenting Program Educator
Youth and Family Programs
04.2008 - 10.2020
General Education Diploma -
Enterprise High School
Certificate -
The University of Queensland
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