Luisa Galvez
Jacksonville,Florida
Summary
I am a proactive and positive individual, dedicated to achieving goals. I am bilingual and have extensive knowledge of Human Resources and Medical Health, along with a strong commitment to customer service. Enthusiastic and focused, I consistently strive to meet objectives.
I am driven and motivated to collaborate closely with both customers and coworkers to create a supportive environment.
Overview
6
6
years of professional experience
Work History
Prior Authorization Representative
Panamericancommunications
Remote
02.2024 - 04.2025
- Contacted insurance companies to proceed with the retro authorization requests needed for performed tests and procedures.
- Coordinated with healthcare providers to gather necessary patient information for prior authorization requests.
- Followed all Medicare, Medicaid, HIPAA, and private insurance regulations and requirements.
- Collaborated with insurance companies to clarify coverage details and resolve issues related to prior authorization.
- Made outbound calls to insurance companies, patients, and physicians to perform patient eligibility checks.
- Submitted prior authorization requests by phone to payers.
- Responded promptly to inquiries from providers, members, and other departments within the organization.
- Facilitated communication between health plan representatives, providers, and members when needed.
Customer Service
OMNI INTERACTIONS
Remote
10.2023 - 02.2025
- Customer service for CFA Institute.
- Developed and implemented customer service policies and procedures to ensure quality customer service.
- Greeted members and provided excellent customer service.
- Resolved customer service issues promptly and courteously.
- Collaborated with senior customer service staff to identify areas for improvement in the customer service process.
- Identified and resolved customer service issues.
- Assisted in troubleshooting escalated customer service issues.
- Promoted available products and services to customers during service, account management and order calls.
- Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
Medical Customer Service Representative
OMNI INTERACTIONS
Remote
10.2022 - 06.2023
- Customer service for Carbon Health. Medical clinics.
- Managed smooth and effective communication among physicians, patients, families, and staff.
- Assisted customers during the selection process and helped them choose the perfect products to meet individual needs.
- Increased repeat business using great customer service, problem-solving, and conflict-resolution skills.
- Maintained records of sales activities, such as appointments made, calls placed, and samples distributed.
- Responded promptly to customer calls and emails regarding product issues and complaints.
- Scheduled appointments with established and prospective customers to meet with and discuss corporate offerings.
- Collaborated with new customers to give details about company offerings.
Customer Care Representative
247.ai GT
Remote
09.2021 - 06.2023
- Walmart.com
- Customer service, problem-solving.
- Developed creative solutions to resolve complex problems quickly while minimizing cost impacts on the company.
- Provided accurate, valid, and complete information to customers.
- Determined accurate customer service prices, consistently searching for deals and the best prices.
- Researched resolutions, contacted necessary departments, and responded to the customer by phone and email as a follow-up.
- Maintained up-to-date knowledge of company products, services, and promotions.
- Ensured compliance with company policies regarding privacy laws and data protection regulations.
- Resolved customer complaints promptly and professionally.
Customer Care Representative
EVERISE
Remote
03.2020 - 07.2022
- In charge of the Tires dept and technicians. BJ´s Wholesale Club.
- Support in new waves of the organization.
- Customer service, problem-solving.
- Provided safety information to customers.
- Created detailed reports on customer feedback for management review.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Maintained composure and patience in the face of difficult customer situations, applying de-escalation techniques and positive customer support.
- Researched customer inquiries using available resources such as FAQs and online forums.
- Investigated customer complaints regarding product quality or service rendered.
Administration / Recruitment
FRIENDSHIP HOSTEL
01.2019 - 09.2019
- Supported workforce planning and staffing strategies to align with organizational goals and objectives.
- Analyzed employment-related data and prepared reports.
- Analyzed job descriptions and determined the recruitment plan, timeline, and advertising efforts to fill positions.
- Informed job applicants of duties and responsibilities, compensation, and benefits.
- Managed employee separation processes, including exit interviews and termination paperwork, ensuring a smooth transition.
- Maintained and updated organizational charts, employee handbooks, or performance evaluation forms.
- Hired employees and processed hiring-related paperwork.
- Reviewed job descriptions, identified necessary changes and updated accordingly.
- Greeted visitors and provided general information about the company.
- Created travel arrangements and distributed travel details to appropriate personnel.
Education
BACHELOR'S DEGREE - Industrial Psychology
UMG
09.2021
DIPLOMA - HUMAN RESOURCES
INTERNATIONAL CULMEN
PASSENGER CABIN CREW TRAINING CERTIFICATE - Cabin crew / Flight Attendant
ETAP
Skills
- Great customer service
- Empathy
- Bilingual
- Good at working under pressure
- Responsible
- Organized
- Issue resolution
- Problem-solving
- Healthcare industry
- Multitasking Abilities
- Goal setting
- Adaptability and flexibility
- Teamwork
Languages
English
Proficient (C2)
C2
Spanish
Proficient (C2)
C2
Timeline
Prior Authorization Representative
Panamericancommunications
02.2024 - 04.2025
Customer Service
OMNI INTERACTIONS
10.2023 - 02.2025
Medical Customer Service Representative
OMNI INTERACTIONS
10.2022 - 06.2023
Customer Care Representative
247.ai GT
09.2021 - 06.2023
Customer Care Representative
EVERISE
03.2020 - 07.2022
Administration / Recruitment
FRIENDSHIP HOSTEL
01.2019 - 09.2019
BACHELOR'S DEGREE - Industrial Psychology
UMG
DIPLOMA - HUMAN RESOURCES
INTERNATIONAL CULMEN
PASSENGER CABIN CREW TRAINING CERTIFICATE - Cabin crew / Flight Attendant
ETAP
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