Summary
Overview
Work History
Education
Skills
Languages
Certification
References
Timeline
Generic

Marcos Morales

Miami,FL

Summary

A highly skilled and results-driven Account Manager with 10 years of commercial health experience. Specializes in client relationship management, strategic planning, and market trend analysis. Exceptional problem-solving skills and adaptability for successful outcomes in diverse environments.

Overview

14
14
years of professional experience
1
1
Certification

Work History

Sr. Field Account Manager - Public Sector

United Healthcare
Miami, FL
01.2024 - Current
  • Own the service experience of customers at the field level by working with the UMR Operations Team and other matrix partners, as required, to ensure issues are resolved promptly and accurately, meeting the customers' expectations.
  • Develop and maintain a solid relationship with internal partners in the UMR Service Team to manage the customer service experience.
  • Fully accountable for supporting the SAE in facilitating resolution of all elevated customer service requests by working with the Operations Team and conducting customer consultations as required.
  • Coordinate resolution of pre-implementation service and eligibility issues with the Implementation Team.
  • Accountable for providing a wide range of reporting to identify trends and Performance Guarantees (PGs).
  • Establish and maintain solid and appropriate relationships with customers to maintain persistency.
  • Demonstrate a high level of healthcare industry knowledge, as well as the customers' specific industry.
  • Perform other assignments and responsibilities as required by management.

Field Account Manager - Key Accounts

UnitedHealthcare
Miami, FL
05.2019 - 01.2024
  • Ensured prompt resolution of customer concerns and satisfaction by actively working with the Central Service Team and collaborating with other matrix partners as needed.
  • Develop and maintain a strong relationship with internal partners in the Centralized Service Team to manage the customer service experience.
  • Ensured seamless resolution of escalated customer service requests by collaborating with Centralized Service Team.
  • Regularly facilitate customer meetings with the Central Service Team to assess trends and stay informed about escalating issues and service trends.
  • Established and maintained broker/consultant relationships as needed.
  • Coordinate ordering of enrollment materials/directories for customers.
  • Coordinate resolution of pre-implementation service and eligibility issues with. Implementation Management Organization.
  • Conduct enrollment meetings and customer-sponsored health fairs. Serve as the primary contact for Benefit Coordinators at various state agencies, responsible for resolving service issues, training on various UHC tools and resources, and being a resource for all questions related to the medical plan.
  • Trained and mentored newly recruited Field Account Managers to help them accomplish job targets.

Sr. Bilingual Subject Matter Expert

UnitedHealthcare
Miami , FL
05.2017 - 05.2019
  • Acts as a facilitator to resolve conflicts on team, seen as key team member on project teams spanning more than own function.
  • Identified and addressed internal and external customer needs proactively.
  • Delivered on-the-spot assistance to internal clients by addressing highly escalated complex problems, while also proactively identifying fresh resolutions for external customer concerns.
  • Successfully handle interactions with callers by ensuring appropriate communication strategies are employed: projecting professionalism, instilling confidence in the caller while maintaining a calm demeanor, and skillfully resolving challenging situations as needed.
  • Interacted with escalated callers using knowledge of applicable Service Level Agreements (SLAs) and Performance Guarantees.
  • Ensured consistent communication with escalated callers, delivering status updates and essential information during the resolution process.

Sr. Bilingual Members Benefit Advocate

UnitedHealthcare
Miami , Florida
06.2015 - 07.2017
  • Demonstrate understanding of internal and external factors that may drive caller questions and issues (e.g., recent plan changes, mass mailings, call directing and rerouting, weather emergencies).
  • Collected relevant data and conducted preliminary analysis to identify the extent and complexity of inquiries.
  • Identified and coordinated internal resources across multiple departments to address client situations, escalating to appropriate resources as needed.
  • Provided callers with additional options to resolve their concerns, such as online access to important information, alternative plan benefits and solutions for prescription delays.
  • Achieve first-call resolution consistently to address caller questions and issues effectively.
  • Translated calls for Representatives, handling all lines of business and interpreting Medical, Dental, and Vision-based calls.

Correspondence & Pre-Cert Support Specialist,

Simply Healthcare
Miami , FL
05.2014 - 09.2014
  • Compose Medicare and Medicaid letters in regard to extending, downgrading, approving, and denying members' services after the Medical Directors' review.
  • Maintain CMS and ACHA guidelines when forwarding letters via UPS and USPS and determine disposition of correspondence.
  • Prepare periodic reports on day-to-day basis.
  • Implement new strategy and ideas to ensure work efficiency.
  • Moderate and lead a team to ensure daily duties do not fall out of compliance.

Call Center Quality Monitoring Specialist

Univita health
Miami, FL
09.2011 - 05.2014
  • Operate a system designed to ensure all phone calls are handled professionally and accurately by our company standards, and the standards of our accredited entities.
  • The Monitoring Auditor Specialist will discuss the errors with the representative and provide proper feedback to him/her with the correct information.
  • Provided operational input which enhanced efficiency levels.

Senior Implementation Specialist,

All Med Services/ Univita
Miami, FL
10.2010 - 05.2014
  • Processed Transfer of Care (ToC) referrals efficiently within the organization.
  • Consistently provide prompt, courteous, and excellent service to both internal and external clients, showcasing adaptability in an ever-changing work environment.
  • Promoted cross-functional collaboration to support the organization's goals.
  • Moderated, motivated, and trained employees to optimize their performance.

Education

Business Administration

City College - Fort Lauderdale
Fort Lauderdale, FL

Skills

  • Key Accounts Experience (groups over 100 Employees)
  • Public Sector Experience
  • Escalation Resolution
  • Ability to navigate a complex organization to accomplish customer satisfaction
  • Excellent oral and written communication skills
  • Proficient in Spanish
  • Proficient with medical terminology
  • Proficient in Microsoft applications: Word, Excel, Access, Outlook, PowerPoint
  • Solid Team Player

Languages

Spanish
Full Professional

Certification

  • Florida 2-15 Licensed Insurance Agent (Accident, Health, Life, Variable life & Variable annuities)

References

ERIC NATERA 

VICE PRESIDENT OF BUSINESS  OPERATION FOR OPTUM   

PH: 786.255.8823   

ERICK.C.NATERA@GMAIL.COM    

CHRISTOPHER L. REYES

ATTORNEY   

PH: 305.898.9306  

CHRISLEEREYESESQ@GMAIL.COM     

PATRICIA CORDERO   

NATIONAL ACCOUNT MANAGER  

PH: 305.803.3528  

PATTY.CORDERO@BCBSFL.COM

Timeline

Sr. Field Account Manager - Public Sector

United Healthcare
01.2024 - Current

Field Account Manager - Key Accounts

UnitedHealthcare
05.2019 - 01.2024

Sr. Bilingual Subject Matter Expert

UnitedHealthcare
05.2017 - 05.2019

Sr. Bilingual Members Benefit Advocate

UnitedHealthcare
06.2015 - 07.2017

Correspondence & Pre-Cert Support Specialist,

Simply Healthcare
05.2014 - 09.2014

Call Center Quality Monitoring Specialist

Univita health
09.2011 - 05.2014

Senior Implementation Specialist,

All Med Services/ Univita
10.2010 - 05.2014

Business Administration

City College - Fort Lauderdale

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