Summary
Overview
Work History
Education
Skills
Accomplishments
Skills
Awards
Employee of the month
Languages
Timeline
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Phyllis Montenegro

Monroe,NC

Summary

Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.

Overview

35
35
years of professional experience

Work History

Patient Advocate Lead

Novant Matthews Medical Center
03.2012 - 10.2024
  • Managed patient complaints professionally and efficiently while maintaining strict adherence to HIPAA regulations.
  • Entered details into computer systems and managed database of information.
  • Monitored patient progress throughout treatment course, advocating for adjustments when necessary to optimize outcomes.
  • Liaised between patients and medical staff, facilitating effective communication of needs, preferences, and treatment plans.
  • Assisted patients in understanding individual rights and responsibilities in regards to care, coverage, and payment.
  • Educated patients and families on healthcare options and financial support resources.
  • Responded to patient concerns and questions with compassionate and knowledgeable service.
  • Entered Grievances through Epic to generate formal letters.

Customer Service

Onstar
02.2009 - 11.2011
  • Provided empathetic support for customers experiencing personal difficulties, building rapport and trust in our brand.
  • Exceeded first-call resolution targets by actively listening to customers'' concerns and addressing them thoroughly.
  • Managed a high volume of calls daily, maintaining composure under pressure while providing exceptional service.
  • Addressed customer account discrepancies and concerns.
  • Escalated complicated customer account issues to supervisors and help desk workers.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Provided directions to customers by loading it in the vehicle.

Customer Service

Connextions
12.2009 - 08.2011
  • Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
  • Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
  • Delivered exceptional support during high call volume periods by maintaining composure and professionalism under pressure.
  • Checked insurance making sure pharmacy medication was available and cost was efficient under the tiers.

Patient Account Representative

Mount Carmel Hospital
04.2000 - 06.2009
  • Reviewed insurance eligibility and verified coverage details to minimize claim denials and delays in payment.
  • Worked with outside entities to resolve issues with billing, claims, and payments.
  • Posted payments and processed refunds.
  • Provided exceptional customer service, handling sensitive patient situations with professionalism and empathy.
  • Demonstrated adaptability in navigating complex payer guidelines to maximize reimbursement opportunities for the organization.
  • Identified trends in unpaid accounts, developing targeted solutions for improved revenue recovery.

Patient Financial Specialist

North Shore University Hospital
04.1991 - 12.1999
  • Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
  • Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
  • Delivered exceptional support during high call volume periods by maintaining composure and professionalism under pressure.
  • Educated customers about billing, payment processing and support policies and procedures.
  • Met customer call guidelines for service levels, handle time and productivity.
  • Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
  • Investigated and resolved accounting, service and delivery concerns.
  • Monitored cash drawers in multiple checkout stations and maintained adequate cash supply.
  • Communicated with insurance companies to obtain authorization for procedures.
  • Verified insurance benefits to ensure patient is active.

High dollar Team

Vytra Healthplans
03.1990 - 02.1997
  • Processed claims for doctors as well as hospital
  • Processed workers comp claims
  • Spoke with clients that had issues with their accounts
  • Made corrections on claims that came back denied from the insurance company
  • Received high volume of calls
  • Made outbound calls to insurance claims offices
  • Coded accounts with ICD9 codes and CPT codes.
  • Effectively resolved customer complaints or issues while maintaining a professional demeanor and upholding company standards.

Education

Associate of Arts -

University of Farmingdale
Melville, NY

High School Diploma -

North Babylon High School
Deer Park, NY
06-1981

Skills

  • Problem-solving
  • Active listening
  • Customer service
  • Adaptability and flexibility
  • Computer proficiency
  • Complaint handling
  • Critical thinking
  • Relationship building
  • Call center experience
  • Microsoft Excel
  • Decision-making
  • Microsoft outlook
  • Data collection

Accomplishments

  • Customer Relations - Earned highest marks for customer satisfaction, company-wide.
  • Conflict Resolution - Responsible for handling customer account inquiries, accurately providing information to ensure resolution of product/service complaints and customer satisfaction.

Skills

Awards

  • Employee of the month
  • Highest copay collected
  • Dedicated worker
  • Sunshine Award

Employee of the month

I was recognized for going above and beyond when dealing with a customer. Having a positive attitude dealing with a situation and ensuring the customer was pleased with the resolution.

Languages

English
Full Professional

Timeline

Patient Advocate Lead

Novant Matthews Medical Center
03.2012 - 10.2024

Customer Service

Connextions
12.2009 - 08.2011

Customer Service

Onstar
02.2009 - 11.2011

Patient Account Representative

Mount Carmel Hospital
04.2000 - 06.2009

Patient Financial Specialist

North Shore University Hospital
04.1991 - 12.1999

High dollar Team

Vytra Healthplans
03.1990 - 02.1997

Associate of Arts -

University of Farmingdale

High School Diploma -

North Babylon High School
Phyllis Montenegro