Myriam De La Rosa
Houston
Summary
Experienced Customer Service Representative with a strong background in the healthcare industry, specializing in assisting members with their medical benefits and supporting providers with claims. Proficient in both English and Spanish, with a proven ability to communicate effectively with diverse populations. Known for demonstrating exceptional empathy and understanding, ensuring a positive experience for all clients. Dedicated to delivering high-quality service and resolving issues promptly and efficiently.
Overview
10
10
years of professional experience
Work History
Senior Call Center Representative
Texas Children's Health Plan
09.2021 - Current
- First point of contact for assistance or information regarding eligibility, benefits, authorizations, claims, referrals and/or any other member/provider demands.
- Identify and handle a variety of routine to complex customer or prospect inquiries or requests.
- Educate members about their health coverage benefits and services.
- Assist providers with claim questions, such as claim denials, allowed amounts paid, how to appeal and correct claims.
Intake Specialist
Jim S. Adler And Associates Law Firm
06.2014 - 09.2021
- Answered phone calls and provided new clients with required paperwork to initiate service.
- Increased customer satisfaction with timely follow-ups, ensuring all necessary documentation was collected and processed promptly.
- Asked a series of questions for the purpose of compiling data, and then used the data
to determine the best next course of action for that client. - Maintained positive attitude and effectively de-escalated clients during crisis
situations.
Education
High School Diploma -
Lamar High School
Houston, TX06.2012
Skills
- Fluent in Spanish
- Inbound and outbound calling
- Verbal and written communication
- Call Center Customer Service
- Problem-solving skills
- Attention to Detail
Timeline
Senior Call Center Representative
Texas Children's Health Plan
09.2021 - Current
Intake Specialist
Jim S. Adler And Associates Law Firm
06.2014 - 09.2021
High School Diploma -
Lamar High School
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