Lisette Rodriguez

Perform research, analysis, documentation, and interpretation for proper provider reimbursement. Responsibilities included, but not limited to updating, maintaining, review fee scheduling and pricing structures to ensure contracted rates and reimbursement policies are priced and applied accurately.

• Addressing inbound calls in a fast paced environment from Providers inquiring about benefits, credentialing and claims.
• Calls included providing claim details, determining the appropriate policy and procedure for the resolution of the denied claim, answering complex benefits questions, and providing credentialing guidance.
• Answering complex benefits questions, and providing credentialing guidance.
• Reviewed member benefits to verify insurance coverage and eligibility for services.
• Performed data entry tasks including medical record review requests.
• Identified discrepancies and submitted claim-adjusted requests to resolve providers' billing concerns.
• Promoted one call resolution by resolving inquiries and concerns on first call.

• Ensured that all paperwork was properly filed according to established procedures.
• Filed pleadings and appeals with court clerks to expedite trial proceedings.
• Mailed and arranged for delivery of legal correspondence to clients, witnesses and court officials.
• Corresponded daily with clients, insurance adjusters, doctors and attorneys.
• Prepared summaries of depositions, interrogatories and testimony for attorney review.
• Handled telephone calls, meeting plans and conference organization requirements.
• Processed incoming mail on a daily basis.
• Knowledge of legal practices, terminology, docketing, e-filing and format for legal documents.
• Interpersonal skills necessary to communicate by e-mail, telephone, and in person to provide case information.

• Conduct proactive consultative needs analysis for new and existing customers.
• Providing product solutions that meet the needs of each customer.
• Simultaneously communicate via phone, email, and chat, while working in a fast-paced environment.
• Utilize strong selling and influencing skills to exceed revenue targets, retention, accuracy, and customer experience goals.
• Build relationships and interact with the membership line of business partners to increase understanding of the products and services offered.
• Scheduled or dispatched workers, equipment or service vehicles to locations using radios or telephones.

• Provided ongoing coaching and feedback to tellers on their job performance.
• Monitored and maintained security procedures to protect both staff and customers.
• Monitored daily cash levels in the vault and reconciled discrepancies.
• Tracked inventory levels of supplies necessary for daily operations.
• Provided excellent customer service while processing transactions, and recommending additional products and services to meet customer's needs.
• Provide transaction approvals in accordance with the bank’s policies and procedures when needed.
• Supervised group of four or more tellers.
• Activities included scheduling, oversight of employees, and customer satisfaction.