Rachel Castaneda
Corpus Christi,TX
Summary
Qualified Engagement Coordinator with strong background in health plan management and client support. Successfully enhanced member satisfaction through effective communication and streamlined processes. Demonstrated expertise in policy interpretation and benefits administration.
Overview
10
10
years of professional experience
Work History
Health Plan Specialist II
Medica
04.2023 - Current
- Participated in ongoing training programs to stay current on industry trends, regulations, and best practices for optimal job performance.
- Educated members on available benefits and resources, empowering them to make informed health decisions.
- Served as a subject matter expert on various aspects of health plans during team meetings and training sessions, increasing overall knowledge within the department.
- Enhanced member satisfaction by effectively addressing and resolving health plan inquiries and concerns.
- Managed a high volume of complex cases, ensuring timely resolution while maintaining strict confidentiality standards.
Billing Representative
Express Scripts
08.2016 - 08.2022
- Provide patients with current account information
- Update patient accounts as requested
- Provide copay assistance information to patients as requested
- Redirect patients to dedicated teams as required
- Escalate calls to supervisors as needed
- Track shipments for patients as requested
- Assist patients with processing payments
- Rebill or bill copay, insurance properly as needed
- Update insurance as needed if there are any changes
- (615) 850-5050
Patient Care Advocate
Express Scripts
10.2015 - 05.2021
- Provide patients with current account information
- Update patient accounts as requested
- Provide copay assistance information to patients as requested
- Redirect patients to dedicated teams as required
- Escalate calls to supervisors as needed
- Track shipments for patients as requested
- Assist patients with processing payments
- (615) 850-5050
Education
Bachelor of Arts - Psychology
Texas A&M University, Corpus Christi, TX
Corpus Christi05-1998
Skills
- HIPAA compliance
- Claims processing
- Microsoft office
- Insurance verification
- Benefits
Timeline
Health Plan Specialist II
Medica
04.2023 - Current
Billing Representative
Express Scripts
08.2016 - 08.2022
Patient Care Advocate
Express Scripts
10.2015 - 05.2021
Bachelor of Arts - Psychology
Texas A&M University, Corpus Christi, TX
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