Mariana Battle
Sanford,NC
Summary
Resourceful Customer Service Representative known for high productivity and efficient task completion. Specialized in communication, problem-solving, and time management skills, ensuring smooth operations in customer service environments. Excel in listening, empathy, and patience, which are crucial for addressing customer needs effectively and building positive relationships.
Overview
5
5
years of professional experience
Work History
Tech support specialist
Alorica
Sanford, NC
06.2024 - 01.2026
- Resolved billing questions and clarified copay, deductible, and premium information.
- Guided members through pharmacy, provider, and referral support options.
- Reviewed claims details and explained claim status using UnitedHealthcare systems.
- Processed prior authorization requests and routed cases to appropriate departments.
- Documented member interactions in UnitedHealthcare records with accurate case notes.
- Managed multiple chat conversations while maintaining clear, professional communication.
- Monitored chat queues for incoming requests from customers requiring assistance.
- Collected customer details and routed requests to proper departments.
Healthcare Customer Service Representative
United Health Care
08.2020 - 05.2023
- Respond to inbound customer and client inquiries regarding AEP, LEP, prescription mail orders, account activation, multi-factor authentication (MFA) resets, products, billing, equipment, claims, and reported issues; make outbound calls as needed to resolve concerns.
- Communicate with customers, healthcare providers, and other claim-related third parties to obtain and provide necessary information for medical and pharmacy claims.
- Verify medical authorizations and referrals to ensure accuracy and compliance with established requirements.
- Review initial medical and pharmacy claims, validate information submitted by patients and providers, and ensure documentation is accurate and complete for insurance reimbursement processing.
- Manage internal communications and service requests involving clients, teams, and other departments to ensure timely resolution.
- Maintain electronic records and databases, making updates and corrections as necessary to ensure data accuracy.
- Reduce service request resolution times by 20% through effective use of customer relationship management (CRM) tools and streamlined workflows.
- Meet or exceed key performance indicators (KPIs) established by the business.
Education
Southern Lee High School
Sanford, NcSkills
- Claim processing
- Prior authorization
- CRM systems
- KPI tracking
- Microsoft Excel, Microsoft Word, Microsoft Teams
- ServiceNow, Cisco webex, APPLE, WINDOWS, Epic
- Microsoft Excel, Microsoft Word, Microsoft Teams,
- ServiceNow, Cisco webex , APPLE , WINDOWS, Epic
- Systems, NexTech, OPTUM, Salesforce,CITRIX,CRM
- Office administration & operations
Timeline
Tech support specialist
Alorica
06.2024 - 01.2026
Healthcare Customer Service Representative
United Health Care
08.2020 - 05.2023
Southern Lee High School