Nazly Cuero Restrepo
Tallahassee,FL
Summary
Proven track record in enhancing customer experience and resolving complex issues, demonstrated during tenure at Anthem Inc. Skilled in data entry and critical thinking, consistently maintaining a 99.9% quality score. Excelled in roles requiring customer service excellence and problem-solving abilities, contributing to significant process improvements.
Overview
5
5
years of professional experience
Work History
Customer Service Representative
Health Help Project
10.2023 - 07.2024
- Sort and file extensive medical records
- Handle 750-800 private pre-certification for providers office weekly
- Extensive knowledge on medical terminology
- Identify proper procedure per patient’s based on medical records and condition
- Administer incoming and outbound calls
Customer Service Representative
Intuition College Savings Solutions
11.2022 - 10.2023
- Responsible for customer service functions to include; answering inbound phone calls from prospective and existing customers and/or placing outbound calls
- Periodically have input into process improvement for customers, managers and client representatives
- Assist potential customers with enrollment inquiries
Interpreter
Cyracom International
01.2021 - 11.2022
- Coach new hires
- Assist Spanish speakers via phone by interpreting what is being stated by hospital, clinic, government agency personnel
- Data input of interpretation into system
- Handle incoming calls
- In charge of of computer system performance on a daily basis
- Translate in everyday life, production, and procedure, as well as during meetings
Claims Analyst
Anthem Inc
01.2019 - 12.2020
- Processing a minimum of 168 claims daily
- Medicare crossover claims processing
- Medicaid claims processing
- DME Claims Processing
- CPT Code knowledge
- Maintaining a 99.9% quality score in order to meet department goals
- Manual pricing experience
- Claims workstation trained
- Behavioral health processing knowledge
- Audit Experience at the Tier 1 level
- Participation in, or support audits
Education
Christian Senior High School
Houston, TXSkills
- Customer Service
- Problem-solving abilities
- Active Listening
- Critical Thinking
- Data Entry
- Customer Relations
- Problem Resolution
- Computer Proficiency
- Conflict Resolution
- Complaint Handling
- Microsoft Excel
Languages
Spanish
Native or Bilingual
Timeline
Customer Service Representative
Health Help Project
10.2023 - 07.2024
Customer Service Representative
Intuition College Savings Solutions
11.2022 - 10.2023
Interpreter
Cyracom International
01.2021 - 11.2022
Claims Analyst
Anthem Inc
01.2019 - 12.2020
Christian Senior High School
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