Work Preference
Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic
Luisa Galvez
Open To Work

Luisa Galvez

Industrial Psychology
Jacksonville,Florida

Work Preference

Job Search Status

Open to work
Desired start date: Open to discussion

Desired Job Title

Prior Authorization RepresentativeHuman Resources SpecialistHuman Resources CoordinatorSupervisorTeam Leader

Work Type

Full TimePart TimeContract WorkGig WorkConsultingSeasonal Work

Location Preference

On-SiteRemoteHybrid
Location: Jacksonville, Florida
Open to relocation: Yes

Salary Range

$45000/yr - $100000/yr

Important To Me

Career advancementWork-life balanceCompany CultureFlexible work hoursPersonal development programsHealthcare benefitsWork from home optionPaid time off401k matchPaid sick leaveTeam Building / Company RetreatsStock Options / Equity / Profit Sharing

Summary

I am a results-oriented bilingual professional with experience in human resources and healthcare. I am committed to delivering excellent customer service and supporting team success. I have been recognized for my strong work ethic, adaptability, and ability to quickly learn and grow in fast-paced environments. I excel at building positive relationships with customers and colleagues and contributing to a collaborative, supportive, high-performing team. I am motivated to take on greater responsibilities and help guide team efforts to achieve consistent results while supporting organizational goals and ensuring compliance.

Overview

7
7
years of professional experience

Work History

Support Center Representative

Molina Healthcare
Jacksonville, FL
05.2025 - Current
  • Assisted members with healthcare enrollment and benefits information.
  • Coordinated communication between members and healthcare providers.
  • Resolved member inquiries regarding claims and service issues.
  • Educated members on available health programs and resources.
  • Collaborated with the team to improve member satisfaction initiatives.
  • Maintained accurate records in the member management system.
  • Resolved customer complaints in a professional manner while remaining empathetic to their concerns.
  • Demonstrated strong problem-solving skills when faced with challenging situations or complex inquiries from customers.
  • Demonstrated exceptional service skills by going above and beyond to satisfy customers on the phone and in person.
  • Participated in training sessions designed to improve overall job performance.
  • Performed administrative tasks such as filing documents and updating records.
  • Escalated unresolved issues to the appropriate departments for further investigation.
  • Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.

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
Native/ Bilingual
Spanish
Native/ Bilingual

Timeline

Support Center Representative

Molina Healthcare
05.2025 - Current

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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