Nancy Rios
Brownsville,TX
Summary
Dedicated customer service professional with over 17 years of experience, with a proven track record at UnitedHealthcare, excelling in problem-solving and relationship building. Adept at resolving complex issues and ensuring customer satisfaction through effective communication and conflict resolution. Skilled in medical billing and HIPAA compliance, consistently delivering high-quality support in fast-paced environments.
Overview
24
24
years of professional experience
Work History
Customer Advocate
UnitedHealthcare
10.2010 - 08.2025
- Listened to customers in actively to assess issues and provide accurate information.
- Documented customer concerns and inquiry resolutions in internal computer system.
- Researched and resolved account and service problems with friendly, knowledgeable support.
- Evaluated customer service standards, policies and procedures to verify customer service goal achievement.
- Processed insurance company denials by auditing patient files, researching procedures, and diagnostic codes to determine proper reimbursement.
Customer Service Representative
T-Mobile
06.2008 - 01.2009
- Responded to customer requests for products, services, and company information.
- Followed up with customers about resolved issues to maintain high standards of customer service.
- Identified and resolved discrepancies and errors in customer accounts.
- Cross-trained and backed up other customer service managers.
Customer Service Representative
Convergys
05.2002 - 09.2005
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Addressed customer account discrepancies and concerns.
- Placed outbound customer service or customer satisfaction calls to follow up on issues.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Assisted customers with Spanish-language inquiries in a timely and professional manner.
Library Student Assistant
University of Texas Rio Grande Valley
08.2001 - 07.2002
- Aided patrons with use and access to technology, resources and materials.
- Maintained and updated records of current collection.
- Checked out and checked in items using library computer system.
- Answered general questions in person, by phone and over email.
Education
No Degree - Psychology
The University of Texas Rio Grande Valley
Brownsville, TXHigh School Diploma -
Porter Early College High School
Brownsville, TX06-2002
Skills
- Problem-solving
- Remote office availability
- MS office
- Data management
- Conflict resolution
- Dependable and responsible
- Multitasking
- Teamwork and collaboration
- Relationship building
- Troubleshooting
- Microsoft office
- CPT coding
- HIPAA compliance
- Claim submission
- Medical billing procedures
- Healthcare claim coding
- Claims processing
- Data entry
Accomplishments
UnitedHealthcare 2012 Tier 1 Top Performer (In recognition of meeting and exceeding goals based on performance metrics).
Languages
Spanish
Full Professional
Timeline
Customer Advocate
UnitedHealthcare
10.2010 - 08.2025
Customer Service Representative
T-Mobile
06.2008 - 01.2009
Customer Service Representative
Convergys
05.2002 - 09.2005
Library Student Assistant
University of Texas Rio Grande Valley
08.2001 - 07.2002
No Degree - Psychology
The University of Texas Rio Grande Valley
High School Diploma -
Porter Early College High School
2012 Tier 1 Top Performer
In recognition of meeting and exceeding goals based on performance metrics.