Summary
Overview
Work History
Education
Skills
References
Timeline
Generic

Monica Rivera-Rodriguez

Deltona,USA

Summary

Detail-oriented Customer Support Representative with a history of success in high-pressure environments. Im recognized for my exceptional communication skills, adept problem-solving abilities, interpersonal skills, and adaptability.

Overview

9
9
years of professional experience

Work History

Customer Support

Mphasis
Lake Mary, FL
03.2020 - Current
  • Handled provider inquiries regarding eligibility verification, claim status, payments, and appeals.
  • Strictly adhered to HIPAA guidelines for caller verification, and ensured compliance with patient privacy policies during all communications.
  • Initiating escalations for denial review, tracing missing payments, or claim processing errors.
  • Communicating with providers or billing departments via email. Ensuring accuracy and one email resolution.
  • Returning voicemails when necessary.
  • Consistently achieving a minimum passing score of 90% or higher in all quality checked calls. Meeting and exceeding satisfactory scores across all key performance indicators.

First Notice of Loss Agent

SWBC\Mphasis
Lake Mary, US
09.2019 - 03.2020
  • Actively listen to customers to understand the circumstances of the incident, asking probing questions to gather the necessary information for claim evaluation.
  • Address customer inquiries and concerns regarding the claims process, providing support and reassurance throughout the initial contact.
  • Answer calls, emails, or online submissions from policyholders reporting a loss, accurately capturing details such as the policy number, date and time of the incident, location, nature of the loss, and involved parties.
  • Accurately input all relevant information into the company's claims management system, including incident details, policyholder data, and initial coverage assessment.
  • Demonstrated effective communication by remaining calm and solution-focused in challenging scenarios.

Sales Advocate/ Team Lead - Key Holder

Cricket Wireless
Altamonte Springs, US
03.2019 - 09.2019
  • Operated register, handled cash and processed credit card transactions.
  • Resolved customer complaints in a timely manner.
  • Established protocols to minimize inventory losses.
  • Monitored competitors' prices, products, new products and delivery schedules.
  • Assisted customers in selecting products that best fit their needs.
  • Greeted and assisted customers to foster positive experiences.
  • Coordinated with logistics teams to ensure timely delivery of products to customers.
  • Recruited, hired and trained new hires to optimize profitability.
  • Maximized sales by keeping areas tidy, fully stocked and correctly priced.

Customer Service Representative

Alorica (U.S Bank)
Lake Mary, US
06.2017 - 01.2018
  • Resolved complex problems by working with other departments to provide solutions that meet customer needs.
  • Initiate actions addressing suspected fraud cases.
  • Ensured accuracy in client records.
  • Maintained high performance by surpassing the 90% threshold in quality assessments.
  • Processed incoming calls by recording and verifying customer details like names, addresses, and credit card information.
  • Maintained a high level of professionalism when dealing with difficult customers.
  • Monitored customer satisfaction levels through surveys and feedback forms.

Healthcare Coordinator

HealthFair
Casselberry, FL
03.2016 - 04.2017
  • Responded effectively to member calls ensuring clarity and resolution.
  • Scheduling appointments for regular checkups, EKGs, or requested blood work.
  • Facilitated scheduling of required transportation for appointments and home visits as needed.
  • Verified eligibility and calculated out-of-pocket costs before appointments.

Education

A.S -

CITY COLLEGE
Altamonte Springs, FL
05-2026

HIGH SCHOOL -

SEMINOLE STATE COLLEGE
05.2010

Skills

  • Customer Service
  • English/Spanish Bi-lingual
  • Proficient in Typing (35WPM)
  • Team Leadership
  • Goal-oriented mindset
  • Organizational skills
  • Customer complaint resolution
  • Critical thinking
  • Time Management

References

  • Sandra Lopez, (407)-534-3168, Recruiter and Manager at HealthFirst

Timeline

Customer Support

Mphasis
03.2020 - Current

First Notice of Loss Agent

SWBC\Mphasis
09.2019 - 03.2020

Sales Advocate/ Team Lead - Key Holder

Cricket Wireless
03.2019 - 09.2019

Customer Service Representative

Alorica (U.S Bank)
06.2017 - 01.2018

Healthcare Coordinator

HealthFair
03.2016 - 04.2017

A.S -

CITY COLLEGE

HIGH SCHOOL -

SEMINOLE STATE COLLEGE

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Monica Rivera-Rodriguez