Lizbeth Orozco
Jurupa Valley,CA
Summary
Seasoned and dedicated customer service professional knowledgeable in the healthcare insurance industry. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires and providing customized solutions to build loyalty.
Overview
18
18
years of professional experience
Work History
Tier III Customer Service Representative
Kaiser Permanente
03.2020 - Current
- Represents Kaiser Permanente Health plan by Answering and documenting incoming contacts through phone or KANA email system to determine their nature and respond to complex inquiries related to specialized product lines or queues
- Responsible for increasing customer satisfaction and retention by providing members, customers, patients, and providers with accurate consistent, timely and meaningful information
- Evaluates data and performs research to determine and implement the appropriate course of action to resolve customer dissatisfaction or complaints and/or coordinate service recovery to improve member experience
- Aids with kp.org registration, navigation: setting up of visiting member profiles for all KP regions, assigning medical record numbers and tech support for internal partners and insurance brokers
- Assist members with premium billing, make payments, electronic funds transfer inquiries and set up, reinstatement evaluation and requests
- Assist with 1095 tax form inquiries and reprints
- Aids with medical billing, assists with payments, payment plans and adjusts charges as needed while educating members/patients regarding their plan benefits and retaining satisfaction
- Aids in specialty queues pertaining to expansion markets and tiered products
- Provides members and providers with claim status, claim payment information and service review
- Aids Medicare members for multiple Kaiser Permanente regions
- Aids brokers and group administrators in the client services unit with literature requests and contract inquiries
- Provides content support for fellow co-workers
- Assist the department in meeting customer needs and reaching department expectations.
Tier 1 Customer Service Representative
Kaiser Permanente
08.2018 - 03.2020
- Represented Health Plan by answering and documenting all incoming contacts
- Required to effectively interact with diverse work units
- Assisted members with payments for their monthly premium as well as answered any billing inquiries
- Sent hand offs as needed for account review and reinstatement requests for both individual plans and on exchange plans
- Provided members and prospects with plan rates, aided with benefit inquiries and coverage details
- Provided online support to members for our kp.org website and utilized KANA messaging system to assist members and prospects with inquiries pertaining to the health plan or the organization.
Customer Service Representative
Kaiser Permanente
05.2006 - 08.2018
- Answered incoming calls and assisted members with facility information
- Assist members with account inquiries and payments
- Assist members with health plan benefit information
- Assist members with billing
- Helped department meet customer needs and meet service level goals.
Education
Bachelor of Science - Business Administration
COLORADO TECHNICAL UNIVERSITY
03.2024
Associate of Science - Business Administration
SAN JOAQUIN VALLEY COLLEGE
12.2004
Skills
- Over 17 Years of customer service experience in a healthcare setting
- Strong knowledge of the insurance industry, health plans, policies, and benefits
- Extensive working knowledge of Mainframe, CHATS, KANA, and EpicWorking knowledge of MS word, MS Excel, MS PowerPoint, MS Teams, and MS Outlook
- Knowledge of medical terminology
- Excellent verbal and written communication skills
- Bilingual, Spanish/English
- Customer Data Confidentiality
- De-Escalation Techniques
Timeline
Tier III Customer Service Representative
Kaiser Permanente
03.2020 - Current
Tier 1 Customer Service Representative
Kaiser Permanente
08.2018 - 03.2020
Customer Service Representative
Kaiser Permanente
05.2006 - 08.2018
Bachelor of Science - Business Administration
COLORADO TECHNICAL UNIVERSITY
Associate of Science - Business Administration
SAN JOAQUIN VALLEY COLLEGE