Mirella Dominguez
Dallas,Tx
Summary
Experienced team leader with a proven track record of enhancing customer satisfaction through effective escalation management and training initiatives. Adept at coordinating cross-departmental communication, managing performance reporting, and ensuring strict adherence to HIPAA compliance and operational protocols.
Overview
11
11
years of professional experience
Work History
Claims specialist
Careington International
05.2024 - Current
- Analyze claim coverage with insurance carriers to ensure claims are paid accurately
- Analyzed, audited, and resolved outstanding, denied, or incorrectly paid claims to improve claims processing accuracy
- Maintained high accuracy in entering critical information into claims management system, ensuring seamless processing
- Processed departmental claims promptly per company policy, facilitating timely resolution for stakeholders
- Review and process member appeals
- Processed escalated claims within a 24-48 hour timeframe
- Managed special projects requested by supervisor or team lead.
Team Lead
Careington International
12.2023 - 05.2024
- Managed and supervised on-the-job training for new hires, enhancing orientation effectiveness and improving retention rates.
- Successfully managed escalated member and provider calls, resulting in a 20% increase in customer satisfaction scores
- Acted as liaison between contact center and departments to streamline communication and resolve issues.
- Served as subject matter expert in Help Desk and Teams, offering guidance on over 30 dental insurance and discount programs to Customer Care Representatives.
- Reported recurring escalation issues to the department supervisor/manager to capitalize on training opportunities.
- Ensure HIPAA compliance for departmental filings and consistently keep prompt completion of tasks.
- Creates and keeps departmental performance reports.
- Supported additional departments to facilitate project completion, ensuring timely delivery of services.
- Managed various departmental records to ensure comprehensive documentation.
- Responsible for keeping exact records of received items, completed tasks, and pending assignments daily.
Customer Service Specialist
Careington International
10.2020 - 12.2023
- Answered incoming customer service calls professionally, ensuring accurate and timely responses to customer inquiries.
- Escalated calls to supervisors for complex customer issues.
Courtesy Booth Assistant
Fiesta Mart
10.2016 - 09.2020
- Promote sales of money orders and various tickets
- Conducted inspections of department to uphold company standards for sanitation, shrink, and customer flow.
- Supported cash management processes to ensure accurate financial records. and sales reports reconciliation.
- Verified cash trays to ensure accuracy in cash management.
- Ensured accuracy of bank deposits and data records.
- Check vendor invoices for accuracy.
- Complete all audit paperwork effectively.
- Report any shortages to relevant personnel.
- Maintain pricing standards.
Cashier
El Rio Grande
02.2016 - 10.2016
- Be knowledgeable about the company's products and services and customer-related policies.
- Provide correct and relevant information to customers and address their concerns.
- Processed customer requests for changes in orders or services. and give refunds promptly and courteously.
Receptionist
Camionetas Centauro
04.2015 - 02.2016
- Answer client inquiries about destinations, prices, departure/arrival times, directions to terminal.
- Sell and process ticket orders by phone, or in person.
- Call customers to inform them of changes or cancellations of scheduled runs.
- Closed terminal at end of day to secure operations. and prepare cash bank deposits, sales report, and safe box deposit.
Education
High School Diploma -
Sunset High School
Dallas, TX, USASkills
- Bilingual communication
- Claim analysis
- Multi-tasking abilities
- Organizational skills
- Time management
- Interpersonal skills
- Problem-solving
- Leadership qualities
- Attention to detail
Awards
Commitment to outstanding service award, 01/01/23
Languages
Spanish
Native/ Bilingual
Timeline
Claims specialist
Careington International
05.2024 - Current
Team Lead
Careington International
12.2023 - 05.2024
Customer Service Specialist
Careington International
10.2020 - 12.2023
Courtesy Booth Assistant
Fiesta Mart
10.2016 - 09.2020
Cashier
El Rio Grande
02.2016 - 10.2016
Receptionist
Camionetas Centauro
04.2015 - 02.2016
High School Diploma -
Sunset High School