Summary
Overview
Work History
Education
Skills
References
Languages
Accomplishments
References
Timeline
Generic

LIDIA E HURTADO

Santa Ana,CA

Summary

  • Licensed Certified Enrollment Counselor offering advanced knowledge of methods, comprehensive assessments and effective enrollment.
  • Skilled in direct supervision, activity planning and organization. Thrives in high stress professional environments.
  • Dedicated to delivering the highest quality of compassionate care. Driven Patient Care Coordinator adapt at planning care, coordinating teams and making strategic improvements.
  • Decisive leader and creative problem solver with 10 years of experience. Collaborates within team in monitoring progress and adjusting plans to achieve target results. .
  • Energetic dedicated to efficient and effective collaboration between teams, patients and families. Outgoing professional with collaborative and flexible approach to reaching mutually beneficial resolutions.
  • Hardworking and passionate job seeker with strong organizational skills eager to secure entry-level Social Services position in social services environment. Ready to help team achieve company goals.

Dedicated and adaptable professional with a proactive attitude and the ability to learn quickly. Strong work ethic and effective communication skills. Eager to contribute to a dynamic team and support organizational goals. Hardworking employee with customer service, multitasking, and time management abilities. Devoted to giving every customer a positive and memorable experience. An organized and motivated individual, eager to utilize time management and organizational skills across diverse settings. Seeking entry-level opportunities to enhance abilities while contributing to company growth.

Overview

25
25
years of professional experience

Work History

Sr. OneCare Customer Service

CalOptima
Orange, CA
06.2022 - Current

Call center environment

Investigate and resolve intricate customer problems, including billing disputes, technical issues, and product concerns, requiring in-depth knowledge of company policies and procedures.

Customer escalation management:

Address escalated complaints from customers, de-escalate situations, and find solutions to ensure customer satisfaction.

Customer retention:

Proactively identify potential customer churn, and take necessary steps to retain customers through personalized service.

Team leadership and coaching:

Provide guidance and support to customer service representatives, sharing best practices and helping them develop their skills.

Quality assurance:

Monitor customer interactions to ensure quality standards are met, identify areas for improvement, and provide feedback to team members.

Performance analysis:

Track key performance indicators (KPIs) related to customer service, identify trends, and suggest process improvements to enhance efficiency.

Customer feedback collection:

Actively gather customer feedback to identify areas for improvement, and contribute to overall customer experience enhancement.

Knowledge base management:

Maintain and update the internal knowledge base with relevant product information and customer service procedures.

Required skills:

Excellent communication skills.

Ability to clearly explain complex information, actively listen to customers, and effectively communicate solutions.

Problem-solving skills:

Strong analytical ability to identify root causes of customer issues, and develop effective solutions.

Customer service expertise:

Deep understanding of customer service principles, including empathy, courtesy, and professionalism.

  • Approached customers and engaged in conversation through use of effective interpersonal and people skills.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
  • Worked effectively in team environments to make the workplace more productive.

Patient Care Coordinator

Altamed Medical Group
Huntington Beach, CA
10.2016 - 05.2022
  • Prescreen scenarios to assist in health care insurance options and needs
  • Verify Client eligibility via State and County
  • Assist clients in connecting and providing other resources available within the county
  • CBO assistor for Medi-Cal (My benefit Calwin assistor)
  • Use SSA disclaimer to update or upload verifications to Medi-Cal
  • Handled Personal Identifiable information
  • Process Medi-Cal Renewal packets as new applications income based
  • Covered CA (Certified Enrollment Counselor) active
  • Streamline process to better understanding for members or potential members coming in with coverage
  • Liaison to departments to work together as team
  • Reviewed each step of patient care and made proactive adjustments to avert issues
  • Medicare adverse referral
  • Established relationships with patients and external partners to cross-train and support
  • Resolved problems with areas such as communication and billing that could negatively impact services
  • Maintained confidentiality of patient data and condition to safeguard health information
  • Built a strong referral network by developing strategic relationships with general
  • Worked with patients and families to develop future and discuss care actions
  • Coordinated charitable, government and community resources for patients
  • Uphold confidentiality requirements and regulatory compliance guidelines
  • Delivered excellent patient experiences and direct care
  • Increased utilization of preventive care

External Affairs (Certified Enrollment Counselor)

PPOSBC dba More Care Enrollment
Santa Ana, CA
01.2014 - 04.2016
  • Traveled locally and regionally to conferences, workshops and presentations
  • Created a comprehensive set of guidelines to measure program and policy effectiveness
  • Conducted needs' assessments and referred clients to financial, medical, social and community assistance and services
  • Trained staff members at key national partner organizations
  • Educated the public regarding community health resources in correctional facilities, community centers and churches
  • Collaborated with local health departments and other community partners
  • Maintained up-to-date and comprehensive electronic and paper filing systems
  • Established and maintained cooperative relationships with representatives of community, consumer, employee and public interest groups
  • Delivered training for staff development, change management and materials, process and technical controls
  • Directed training and retraining of employees to boost performance and enhance business results
  • Performed forecasting to identify necessary changes for supply chain business
  • Performed customer needs assessments and coordinated resolutions with supply chain and quality teams
  • Streamlined and monitored quality programs to alleviate overdue compliance activities
  • Maintained positive customer relations by addressing problems head-on and implementing successful corrective actions
  • Identified and communicated customer needs to supply chain capacity and quality teams

Customer Service Advisor

M.C. LLC
Irvine, CA
02.2006 - 12.2013
  • Managed quality communication, customer support and product representation for each client
  • Served as the company's only bilingual Spanish/English customer service representative
  • Resolved customer questions, issues and complaints
  • Improved service quality and increased sales by developing a strong knowledge of company's products and services
  • Communicated with customers regarding vehicle issues and potential repairs
  • Organized work records and filed reports
  • Maintained 100% customer service satisfaction rating

Certified Applicant Assistant Medi-Cal (volunteer)

Children’s Health Initiative Of Orange County
Orange, CA
02.2011 - 09.2011
  • Company Overview: Non-Profit organization
  • Attended and participated in community meetings and groups
  • Collaborated with health specialists and civic groups to determine community health needs and the availability of services and to develop goals for meeting needs
  • Planned public outreach workshops to improve outreach strategy
  • Coordinated and monitored daily activities
  • Developed relationships with community referral sources
  • Maintained charts in a timely and accurate manner, met deadlines for documentation and updates
  • Documented all services and collect required data for evaluation
  • Led projects and analyzed data to identify opportunities for improvement
  • Carried out day-day-day duties accurately and efficiently
  • Eliminated downtime and maximized revenue by providing top project quality control
  • Non-Profit organization

Customer Service Cashier/ Tech

EZ Lube
Costa Mesa, CA
01.2000 - 01.2006
  • Assess customer needs and respond to questions
  • Cleaned and straightened work area
  • Received company Employee Performance Award after maintaining record sales achievement for 3 years in a row
  • Operated cash register with proficiency
  • Worked overtime shifts during busy periods
  • Preventing store losses using awareness, attention to detail and integrity
  • Worked as a team member performing cashier duties, product assistance and cleaning
  • Served as the company's only bilingual Spanish/English customer service representative
  • Performed store opening duties, including counting cash drawers and checking all equipment for proper functioning
  • Developed highly empathetic client relationships and earned reputation for exceeding sales goals
  • Conducted training and mentored team members to promote productivity, accuracy and commitment to friendly service
  • Monitored metrics and developed actionable insights to improve efficiency and performance
  • Reached out to customers to help with account and service issues, as well as propose new services and product choices
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction
  • Recommended and upsold new products, resulting in 100% increase in revenue
  • Coordinated paperwork and payments for new orders and replacement parts to obtain speedy service for each customer
  • Created customer support strategy to increase customer retention
  • Wrote and proofed orders to reflect proper pricing and discounts
  • Described product highlights and benefits to help guide purchasing decisions
  • Resolved customer complaints and maintained clean and tidy checkout area
  • Maintained customer satisfaction with quick and professional handling of product returns
  • Monitored self-checkout systems and aided or intervention were required
  • Verified deactivation and removal of Electronic Article Surveillance Tags from products at point of sale
  • Counted money in drawers at beginning and end of each shift
  • Reconciled cash drawer at start and end of each shift, accounting for errors and resolving discrepancies
  • Used POS system to enter orders, process payments and issue receipts
  • Solicited customers to purchase loyalty and item protection plans, successfully bringing in $8 per month in new revenue

Education

Adult Mental Health First Aid USA -

03.2025

Youth Mental Health First Aid USA -

03.2025

High School Diploma -

La Quinta High School

Certificate - Medical Terminology & Anatomy

Regional Occupational Program

Certificate of Competencies - Medical Computerized Insurance Billing

Regional Occupational Program

Certificate of Completion - Certified Applicant Assistant

Medi-Cal Program

Certified Enrollment Counselor -

Covered CA University

CPR certified -

Skills

  • Bilingual Spanish and English
  • Patient Needs Assessment and Referral
  • Database Search and Data Entry Skills
  • Verbal and Written Communication
  • Knowledge of Community Services and Programs
  • Patient Confidentiality and Data Security
  • Caring and Empathetic
  • Communicating with Patients and Families
  • Calm and Effective Under Pressure
  • Administrative and Office Support
  • Insurance Forms Processing
  • Benefits Explanation
  • Counseling and Guidance
  • Time Management and Prioritization
  • 50 WPM Typing Speed
  • Outbound Calling
  • Attention to Detail
  • Retentions and operations
  • Anchoring
  • Understanding manage care programs
  • Active listening
  • Networking
  • Troubleshooting
  • Project planning
  • Attention to detail
  • Data entry
  • Self-Directed
  • Written communication

References

  • Ileanna De Leon, supervisor lead, 626-674-8723
  • Claudia Hoso, personal / old coworker, 562-607-3412

Languages

Spanish, Native or Bilingual

Accomplishments

Cal recognition by CEO Michael Hunn 4/2023 CalOptima Health

Courteous demeanor

Energetic work attitude Community health background Customer service

Expert Medicaid Medical records and documentation

Outreach programming Skilled multi-tasker specialist

Passion for social work Client engagement Community resources specialist

Accomplishments California Legislature Assembly Certificate of Recognition 2015 State of California Senate Certificate recognized by "Childrens health initiative.

References

References available upon request.

Timeline

Sr. OneCare Customer Service

CalOptima
06.2022 - Current

Patient Care Coordinator

Altamed Medical Group
10.2016 - 05.2022

External Affairs (Certified Enrollment Counselor)

PPOSBC dba More Care Enrollment
01.2014 - 04.2016

Certified Applicant Assistant Medi-Cal (volunteer)

Children’s Health Initiative Of Orange County
02.2011 - 09.2011

Customer Service Advisor

M.C. LLC
02.2006 - 12.2013

Customer Service Cashier/ Tech

EZ Lube
01.2000 - 01.2006

Adult Mental Health First Aid USA -

Youth Mental Health First Aid USA -

High School Diploma -

La Quinta High School

Certificate - Medical Terminology & Anatomy

Regional Occupational Program

Certificate of Competencies - Medical Computerized Insurance Billing

Regional Occupational Program

Certificate of Completion - Certified Applicant Assistant

Medi-Cal Program

Certified Enrollment Counselor -

Covered CA University

CPR certified -

LIDIA E HURTADO