Summary
Overview
Work History
Education
Skills
Accomplishments
Certification
Languages
Timeline
Generic

Maria Martinez

San Benito

Summary

Advocate with over 4 years of direct experience (15 years overall) with a focus on managing a daily case load in order to meet deadlines through research, collaboration and root cause analysis.

Overview

21
21
years of professional experience
1
1
Certification

Work History

TIER 3 MEMBER RESOLUTION TEAM

Unitedhealthcare Medicare & Retirement
11.2022 - Current
  • Respond to incoming customer service requests, both verbal and written.
  • Identify and assess customers' needs quickly and accurately.
  • Solve problems systematically, using sound business judgment.
  • Partner with other internal and external business departments to resolve complex customer service inquiries.
  • Monitor delegated customer service issues to ensure timely and accurate resolution.
  • Apply appropriate communication techniques when responding to customers, particularly in stressful situations.
  • Inform and educate new customers regarding benefits.
  • Place outgoing phone calls to complete follow-up on customer service requests as necessary.
  • Respond to customer service inquiries in writing as necessary.
  • Demonstrate competency in claims, eligibility and associated applications.
  • Maintain timely and accurate documentation for all appropriate transactions.
  • Consistently meet established productivity, schedule adherence, and quality standards.
  • Keep management abreast of all outstanding issues, including trending issues.
  • Adapt procedures, processes, and techniques to meet the more complex position requirements.
  • Participate in load balancing.
  • Address special projects, including creating job aids for upload to Knowledge Central.
  • Seek involvement in continuous quality improvement initiatives.
  • Ensure quality customer service for internal and external customers.
  • Provide expertise and customer service support to members, customers, and providers.
  • Direct phone-based customer interaction to answer and resolve a wide variety of inquiries.

ADVOCATE4ME REPRESENTATIVE

UnitedHealthcare Medicare & Retirement
11.2020 - 10.2022
  • Provided members with assistance and resolution regarding claims, benefits, and UHC correspondence;
  • Assisted members with calling providers to resolve claims issues or schedule appointments;
  • Educated members on their health plan and how it works in relation to Medicare
  • Developed an Excel spreadsheet to serve as a template for reporting grievances
  • Serviced delegated and non-delegated plans
  • Hosted Get-to-Green (G2G) Meetings designed to assist recently hired advocates improve statistics
  • Utilized time management to create PowerPoint presentations and training material between calls
  • Provided call shadowing for new advocates and provide feedback for learning opportunities
  • Handled de-escalations on behalf of the Business Manager in Core Member Services – M&R

SALES REPRESENTATIVE

Chemsol Services, Inc.
10.2018 - 10.2020
  • Developed relationships with customers to sell products and meet customer needs;
  • Completed and submitted competitive bids;
  • Planned and organized daily schedule to call on existing and new customers to obtain orders and establish new customers;
  • Ensured customer pricing was updated utilizing an Excel spreadsheet based on inventory and demand

OFFICE MANAGER/GRANT WRITER

ERI Funding Group, Inc.
04.2008 - 09.2018
  • Organized and coordinated office administrative procedures for four (4) businesses (3 S-Corporations and 1 Personal) to ensure organizational effectiveness, efficiency, and safety;
  • Responsible for developing intra-office communication protocols, streamlining administrative procedures, inventory control, office staff supervision, and task delegation;
  • Worked independently in providing administrative and executive support in a wide range of duties;
  • Independently wrote grants to secure millions of dollars in state and federal funds for colleges, universities, non-profit organizations, independent school districts, hospitals, and municipalities;
  • Assisted clients in developing and maintaining budgets ranging from $50,000 to $2,000,000 per year through the development of Excel budget templates
  • Utilized problem-solving skills to resolve issues related to successful implementation of grants
  • Traveled to visit clients to provide technical support, as well as evaluation services for quarterly and end-of-the-year reports required by state and federal agencies
  • Provided support and served as a liaison to ensure clients remained compliant with funding agencies including the Texas Education Agency (TEA), U.S
  • Department of Education (USDOE), and others

OFFICE MANAGER

White Cleaners and Laundry, Inc.
06.2003 - 04.2008
  • Handled all accounts receivable & accounts payable;
  • Reconciled and mailed monthly statement for customers with charge/credit accounts;
  • Updated QuickBooks and general ledgers;
  • Computed hours for payroll;
  • Calculated monthly taxes for the Texas Comptroller;
  • Assisted customers with questions and/or concerns

Education

No Degree -

Texas State Technical College
Harlingen, TX
07.2005

High School Diploma -

Harlingen High School
Harlingen, TX
06.2003

Skills

  • Compliance related issues
  • Oral skills
  • Written skills
  • Presentation skills
  • Customer service
  • Relationship building
  • Analytical skills
  • Problem-solving skills
  • Root cause analysis
  • Critical thinking
  • Organizational skills
  • Attention to detail
  • Collaboration with leaders
  • Employee support
  • Human resource knowledge
  • Influence without direct authority
  • Work independently
  • Fast-paced environment
  • Fluent in Microsoft Office (Word, Excel, PowerPoint, etc)

Accomplishments

  • Offering one-on-one coaching with peers to increase productivity
  • Presenting process changes to peers
  • Converting Process Instructions to Knowledge Central
  • Creating Job Aids for Knowledge Central
  • Employee of the Month: June 2024
  • Creating effective production shortcuts

Certification

  • Net Promoter Score (NPS) Champion Certification (Lessons 1-6), 06/01/22
  • M&R Foundation Certification - Levels 1, 2, and 3, 06/01/22

Languages

Spanish
Native or Bilingual
English
Native or Bilingual

Timeline

TIER 3 MEMBER RESOLUTION TEAM

Unitedhealthcare Medicare & Retirement
11.2022 - Current

ADVOCATE4ME REPRESENTATIVE

UnitedHealthcare Medicare & Retirement
11.2020 - 10.2022

SALES REPRESENTATIVE

Chemsol Services, Inc.
10.2018 - 10.2020

OFFICE MANAGER/GRANT WRITER

ERI Funding Group, Inc.
04.2008 - 09.2018

OFFICE MANAGER

White Cleaners and Laundry, Inc.
06.2003 - 04.2008

No Degree -

Texas State Technical College

High School Diploma -

Harlingen High School

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Maria Martinez