Mercedes Frelix
Plano,Tx
Summary
Proven ability to provide excellent customer service and resolve customer complaints in a timely manner. Possesses strong problem-solving skills and the ability to multitask in a fast-paced environment. Aiming to leverage my abilities to successfully fill the Member Engagement Specialist role on your team.
Overview
7
7
years of professional experience
Work History
Healthcare Customer Service Representative
Humana
11.2020 - Current
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures
- Adhered to HIPAA regulations when handling confidential patient information
- Assisted patients with navigating online portals
- Verified and updated changes in patient, physician, or insurance to maintain proper billing
- Developed comprehensive understanding of Medicare and Medicaid regulations and policies.
- Verified patient insurance coverage before scheduling appointments or providing treatment.
- Referred patients to appropriate health care services or resources.
- Managed approximately 50-100 incoming calls per day from customers.
Data Entry Analyst(Contract)
Dept Of Human Resources
04.2020 - 10.2020
- Entered data into various computer systems accurately using Microsoft Office Suite
- Collaborated with team members to complete large-scale data entry projects in a timely manner.
- Ensured data integrity by consistently cross-referencing sources and double-checking entered information.
- Developed customized spreadsheets for efficient tracking and organization of critical business data.
- Completed data entry tasks with accuracy and efficiency.
- Maintained files, records, and chronologies of entry activities.
USAA Eligibility Specialist
Teleperformance
06.2018 - 04.2020
- Interviewed applicants to obtain and verify information to determine eligibility.
- Maintained a high level of confidentiality when dealing with sensitive information related to clients' cases.
- Interpreted and explained information such as eligibility requirements, application details, payment methods, and applicants' legal rights.
- Assisted clients in completing applications for benefits, providing them with guidance throughout the process.
- Help navigate the online account set up
- Provided member numbers
Education
High School Diploma -
Murrah High School
Jackson, MS05.2018
Skills
- Efficient and Detail-Oriented
- Technical Support
- Medical Insurance Rep
- Email Support
- Salesforce
- Understanding Customer Needs
- Creative Problem Solving
- Call Documentation
- Data Entry
- CRM Software
- Microsoft Word
- Microsoft Excel
- Billing
- Appointment Scheduling
- Insurance Verification
- Active listening
- Empathy and compassion
- Quality assurance
- HIPAA compliance
- Medical terminology
Timeline
Healthcare Customer Service Representative
Humana
11.2020 - Current
Data Entry Analyst(Contract)
Dept Of Human Resources
04.2020 - 10.2020
USAA Eligibility Specialist
Teleperformance
06.2018 - 04.2020
High School Diploma -
Murrah High School
Similar Profiles
Latasha LindseyLatasha Lindsey
Enrollment Representative 1 at HumanaEnrollment Representative 1 at Humana
Swapnil TalokarSwapnil Talokar
Senior Software Engineer at HumanaSenior Software Engineer at Humana
Traci ForbesTraci Forbes
UM Coordinator 2| Team Lead at HumanaUM Coordinator 2| Team Lead at Humana