Osiris Lizbeth Puentes
El Paso
Summary
Dynamic Customer Service Representative with proven expertise at Sagility Health Care in claims processing and insurance verification. Adept at resolving complex issues through effective interdepartmental communication and analytical thinking. Committed to enhancing patient satisfaction and streamlining operations, ensuring compliance with HIPAA regulations while delivering exceptional service.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Customer Service Representative
Sagility Health Care
El Paso
09.2021 - Current
- Assisted patients with inquiries and resolved concerns efficiently.
- Processed insurance claims and verified patient information accurately.
- Coordinated communication between healthcare providers and patients effectively.
- Maintained detailed records of patient interactions and service requests.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Communicated with clients to gather necessary information for claims.
- Handled customer inquiries regarding insurance policy coverage details and payment status updates.
- Collaborated with healthcare providers to verify treatments and ensure accurate claim payments.
Claims Assistant
Dr Anand Cholia
Midland
08.2016 - 08.2020
- Communicated with clients to gather necessary information for claims.
- Assisted in reviewing and analyzing claim submissions for compliance.
- Utilized claims management software to track and update cases.
- Supported the claims adjustment process by providing necessary documentation.
- Maintained confidentiality of client information throughout the claims process.
- Identified areas where processes could be improved upon in order to streamline operational workflow.
- Created reports on a weekly basis outlining current claim statuses and trends.
- Attended monthly meetings with upper management personnel in order discuss any outstanding challenges encountered while processing high volume workloads.
- Ensured compliance with HIPAA regulations when dealing with confidential patient information.
- Managed multi-line phone system, directing calls to appropriate staff members.
- Scheduled appointments and maintained calendar for office personnel.
- Maintained office supplies inventory and ordered replacements as needed.
- Coordinated meetings by preparing rooms and necessary materials.
- Assisted in onboarding new employees by providing orientation information.
- Answered incoming calls, took messages, and transferred calls to appropriate departments or personnel.
- Scheduled and confirmed appointments.
- Provided excellent customer service at all times while interacting with both internal and external customers.
- Assisted healthcare providers with patient examinations and procedures.
- Managed patient records using electronic health record systems.
- Assisted physicians with patient care by taking vital signs, patient histories and preparing patients for examinations.
Education
High School Diploma -
Montwood High School
El Paso, TX05-2005
Associate of Science - Nursing
Midland College
Midland, Texas, TXSkills
- Claims processing
- Insurance verification
- Electronic health records
- Billing procedures
- Multi-line phone management
- Conflict resolution
- Data entry accuracy
- HIPAA compliance
- Interdepartmental communication
- Attention to detail
- Analytical thinking
- Time management
- Team collaboration
- Report generation
- Patient care
- Medical terminology
- Vital signs monitoring
- Customer service
- Problem solving
- Medical billing
Languages
English
Professional
Spanish
Professional
Certification
- Certified Medical Assistant
References
References available upon request.
Timeline
Customer Service Representative
Sagility Health Care
09.2021 - Current
Claims Assistant
Dr Anand Cholia
08.2016 - 08.2020
High School Diploma -
Montwood High School
Associate of Science - Nursing
Midland College