MONALIZA RODRIGUEZ
Spring
Summary
Diligent Advocate with strong background in benefits administration and customer support. Proven ability to resolve complex benefit issues and ensure client satisfaction. Demonstrated skills in effective communication and problem-solving.
Overview
15
15
years of professional experience
Work History
Benefit Advocate
BeneLynk
Houston, TX
09.2024 - Current
- Advocated for clients, ensuring understanding of benefits and eligibility requirements.
- Facilitated enrollment processes, improving client access to health care resources.
- Collaborated with cross-functional teams to streamline benefit application workflows.
- Managed case files, maintaining accurate records and compliance with regulations.
Quality Assurance Specialist
CVS HEALTH-AETNA
Houston, TX
09.2022 - 09.2024
- Conduct standard quality reviews/audits to measure compliance with published policies, procedures, customer, and regulatory guidelines.
- Conducted quality reviews and audits to ensure compliance with policies, procedures, and regulatory guidelines.
- Meet with agents to review performance and trends from calls monitored at their location.
- Monitored quality and effectiveness of work processes to enhance customer satisfaction.
- Facilitated team meetings to analyze trends and gather agent feedback.
- Developed and implemented quality assurance protocols to enhance product reliability.
- Conducted thorough inspections and audits of processes to ensure compliance with regulatory standards.
Member Service Representative
CVS HEALTH-AETNA
Houston, TX
09.2022 - 01.2024
- Answered all incoming group calls, ensuring timely response to member inquiries
- Advocate for our members
- Demonstrated effective time management while handling multiple calls in a busy environment.
- Actively advocated for members by addressing their needs and concerns during interactions.
- Answer all incoming Group calls
- Provided assistance in team chat as a subject matter expert, offering insights and guidance.
- Demonstrated problem-solving skills to resolve member issues effectively on all calls
Medical Assistant
MINIVASIVE PAIN SPECIALIST
Spring, TX
04.2020 - 08.2021
- Greeted patients at check-in and check-out, ensuring positive first and last impressions
- Measured and recorded vital signs for patient assessments. vital signs
- Administered patient assessments and collected medical histories to support treatment plans.
- Assisted in scheduling appointments and managing patient records for optimal clinic efficiency.
- Performed routine lab tests and prepared specimens for analysis, ensuring compliance with protocols.
- Educated patients on medication usage and post-procedure care to enhance recovery outcomes.
- Sanitized, restocked, and organized exam rooms and medical equipment.
Surgical Coordinator
MOUNT SINAI MEDICAL CENTER
Miami Beach, FL
10.2018 - 03.2020
- Scheduling patient appointments and making reminder
- Verify patient demographic information, insurance, and medical history
- Facilitated referrals and authorizations for office visits and procedures, ensuring timely patient access to care
- Coordinated and scheduled surgeries, optimizing patient flow and resource allocation
- Communicate with other facilities for patient medical clearances
- Provide patients with surgery preps and instructions
- Liaised with other facilities to secure medical clearances for patients, streamlining the surgical preparation process
- Coordinated surgical schedules to optimize operating room utilization and enhance patient care.
- Managed patient intake processes, ensuring accurate documentation and compliance with regulatory standards.
- Collaborated with surgeons and nursing staff to streamline pre-operative preparations and improve workflow efficiency.
Member Service Representative
SUNSHINE HEALTH
Sunrise, FL
09.2015 - 10.2018
- Answer 35-50 incoming calls daily
- Assist members with locating medical providers and specialists in their area
- Educated members on plan benefits, enhancing understanding and utilization of services
- Anticipate members' needs to efficiently assist on the call
- Route members to appropriate departments when needed
- De-escalated calls from irate members, resolving issues and improving customer satisfaction
- Verify member eligibility and other insurance
- Consistently meeting quality standards for customer service
- Delivered exceptional member service by addressing inquiries and resolving issues promptly.
- Educated members on benefits, eligibility, and coverage options to enhance understanding and satisfaction.
Customer Service Representative
SHOPLADDER
Pembroke Pines, FL
08.2013 - 09.2015
- Answer all incoming customer service / sales calls
- Defuse escalated situations with irate customers
- Heavy emailing and phone use to keep daily communication with customers
- Managed high volume of emails daily to communicate with customers and phone use to keep daily communication with customers
- Collaborated with management to align department operations with customer needs
- Resolved customer inquiries and complaints through effective communication and problem-solving techniques.
- Assisted in training new staff on service protocols and product knowledge to enhance team performance.
- Input purchase orders and follow up via email and phone with vendors for order statuses
- Handled challenging interactions with irate customers to restore satisfaction with irate customers
Room Reservations Agent
SEMINOLE HARDROCK HOTEL
Hollywood, FL
01.2012 - 06.2013
- Answered phone calls for reservation department, assisting callers with inquiries and providing exceptional customer service
- Processed reservation requests, including changes and cancellations, through multiple channels to ensure accurate and timely bookings
- Answer all phone calls routed to the reservation department and assist the caller using proper phone technique
- Monitored room inventory in absence of Revenue Manager to support efficient reservation management
- Managed room inventory effectively to maximize occupancy rates and enhance guest satisfaction.
- Trained new staff on reservation systems and customer service best practices, fostering a supportive work environment.
- Assist with monitoring room inventory when Revenue Manager is not present
Education
High School Diploma -
Queens Academy Outreach Center
Queens06-2006
Skills
- Benefits administration
- Claims processing
- Healthcare software
- Research
- Trade policy
- Bilingual (Spanish)
- Multitasker
- Organized
- Excellent communication skills
Languages
Spanish
Native or Bilingual
Timeline
Benefit Advocate
BeneLynk
09.2024 - Current
Quality Assurance Specialist
CVS HEALTH-AETNA
09.2022 - 09.2024
Member Service Representative
CVS HEALTH-AETNA
09.2022 - 01.2024
Medical Assistant
MINIVASIVE PAIN SPECIALIST
04.2020 - 08.2021
Surgical Coordinator
MOUNT SINAI MEDICAL CENTER
10.2018 - 03.2020
Member Service Representative
SUNSHINE HEALTH
09.2015 - 10.2018
Customer Service Representative
SHOPLADDER
08.2013 - 09.2015
Room Reservations Agent
SEMINOLE HARDROCK HOTEL
01.2012 - 06.2013
High School Diploma -
Queens Academy Outreach Center