Perla R. Silva
Houston,TX
Summary
Detail-oriented healthcare insurance professional with 7+ years in member services and administrative operations. Expertise in maintaining member records, researching inquiries, and documenting interactions to enhance service workflows. Strong communicator with experience in assisting members and supporting team efficiency. Proficient in computer systems and Microsoft Office, prioritizing accuracy and confidentiality.
Overview
8
8
years of professional experience
Work History
Customer Service Representative
Elevance Health
09.2019 - Current
- Managed inbound calls to address member inquiries.
- Guided members through enrollment, billing, and plan change questions.
- Clarified billing information, enabling members to resolve issues effectively.
- Clarified prior authorization requirements and referral processes for members.
- Reviewed claims and eligibility details using customer service systems.
- Documented call notes and service requests in case management tools.
- Researched authorization statuses for pending member requests.
- Coordinated with provider support teams on claims and coverage issues.
- Provided information on transportation options for members.
- Coordinated patient appointments and follow-up visits, ensuring seamless care continuity.
- Resolved scheduling conflicts and redirected patients to proper services.
- Applied HIPAA guidelines while handling sensitive member information.
- Guided clients on community resources and services, improving their access to support.
Interpreter
Cyracom Language Solutions
03.2019 - 10.2019
- Facilitated interpretation for healthcare providers, hospitals, insurance agencies, and financial institutions, ensuring clear communication during emergency-related situations, including 911 calls.
- Relayed spoken messages accurately between limited English speakers and service representatives, enhancing understanding and access to essential services.
- Followed confidentiality standards for private medical, legal, and customer conversations.
Administrative Assistant
Evins Personnel Consultants
10.2018 - 03.2019
- Entered information into computer systems and maintained administrative records. Reviewed applications and checked documentation for completeness.
- Scheduled appointments and maintained scheduling information.
- Answered and directed calls across multiple phone lines.
- Organized, filed, and maintained documents to support efficient recordkeeping and retrieval.
- Provided administrative assistance to support daily office operations and workflow.
Education
High School Diploma -
Cesar E. Chavez High School
Houston, TXSkills
- Healthcare Insurance Operations
- Data Entry and Record Maintenance
- Member Information Management
- Authorization Status Research
- Insurance Benefits and Eligibility Support
- Claims-Related Support
- Care Coordination Support
- Referral and Provider-Related Inquiries
- Documentation and Record Accuracy
- Data Quality and Information Verification
- Member Services and Issue Resolution
- Correspondence and Document Processing
- Microsoft Office and Excel
- Administrative Support
- Bilingual Communication: English and Spanish
- Team Training Support and Process Guidance
- Healthcare communication
- Customer support
Timeline
Customer Service Representative
Elevance Health
09.2019 - Current
Interpreter
Cyracom Language Solutions
03.2019 - 10.2019
Administrative Assistant
Evins Personnel Consultants
10.2018 - 03.2019
High School Diploma -
Cesar E. Chavez High School