Maricruz Navarro
Weslaco,TX
Summary
Results-driven professional provides customers with tailored solutions to meet needs. Successfully establishes relationships with customers and delivers quality service. Agile individual with excellent communication and customer service skills.
Overview
11
11
years of professional experience
Work History
Licensed Health Insurance Agent
Ttec (TeleTech) - HealthCare Solutions
08.2022 - 12.2023
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Streamlined the insurance application process for clients, resulting in faster approvals and higher satisfaction rates.
- Assisted clients in understanding complex insurance policies, ensuring they made informed decisions when selecting coverage options.
- Educated prospective clients on the benefits of various health insurance options, effectively matching them with suitable plans that met their unique needs.
Research Support Specialist
United Healthcare
09.2012 - 07.2020
- Serve as a resource or Subject Matter Expert (SME) for other team members or internal customers
- Handle escalated calls, resolving more complex customer issues in a one and done manner
- Answer incoming phone calls from customers and identify the type of assistance the customer needs (i.e., benefit and eligibility, billing and payments, authorizations for treatment and explanation of benefits (EOBs)
- Research complex issues across multiple databases and work with support resources to resolve customer issues and / or partner with others to resolve escalated issues
- Provide education and status on previously submitted pre – authorizations or pre – determination requests
Education
Associate of Arts - Social Work
South Texas College
Weslaco, Texas12.2024
Skills
Over 10 years of experience customer service and knowledge in Medicare Advantage part C and D
- Customer Engagement
- HIPAA Compliance
- Compliance knowledge
- Claims Processing
- Customer Complaint Resolution
Timeline
Licensed Health Insurance Agent
Ttec (TeleTech) - HealthCare Solutions
08.2022 - 12.2023
Research Support Specialist
United Healthcare
09.2012 - 07.2020
Associate of Arts - Social Work
South Texas College
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