Summary
Overview
Work History
Education
Skills
Affiliations
Timeline
Generic

Rachel Martinez

Sacramento,CA

Summary

I am a highly qualified, detailed-oriented and hardworking customer service representative with more than 30 years of experience. Proficient in my knowledge of insurance related issues. Proficient in resolving issues with coverage, research, writing, case management and client relations. Expert computing and technology skills including competence in multiple software applications. Responsible Data Specialist bringing abundant experience from varying data entry settings. Well-coordinated and detail-oriented in addressing and resolving system issues to complete assignments. Decisive and analytical problem-solver. Efficient and precise with commitment to finishing jobs quickly and accurately. Proven to work closely with coworkers for effective data management. Skilled in document digitization, office modernization and data organization for enhanced productivity. Meticulous customer service with 30 years of experience in data entry. Expert in streamlining data entry procedures and implementing Microsoft use for modernized offices. Skilled at entering and organizing mass amounts of data quickly and accurately. Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy. To seek and maintain full-time position that offers professional challenges utilizing interpersonal skills, excellent time management and problem-solving skills.

Overview

28
28
years of professional experience

Work History

Medi-Cal Specilaist

XELA/ Gainwell Technologies
10.2022 - 04.2023
  • Completed data entry tasks with accuracy and efficiency.
  • Compiled data and reviewed information for accuracy prior to input.
  • Reviewed and updated client correspondence files and database information to maintain accurate records.
  • Maintained files, records and chronologies of entry activities.
  • Identified data entry errors and reported to necessary departments.
  • Evaluated source documents to locate needed information.
  • Searched, extracted and interpreted information to determine correct input procedure.
  • Communicated with supervisors and colleagues to process data quickly and resolve discrepancies.
  • Verified accuracy of data entered into system to produce error-free reports.

Customer Service Health Representative

Centene Corp.
08.2017 - 05.2022
  • Reviewed account and service histories to identify trends and issues.
  • Greeted customers to facilitate services, determine service needs and accurately input members information to aide in claim issue and members needs.
  • Assisted members each time they called with various health questions.
  • Escalated customer concerns, issue and claim matter to supervisors.
  • Worked with managers to develop service improvement initiatives.
  • Resolved members inquiries per week to consistently meet performance benchmarks, accuracy and volume.
  • Answered various inbound calls per day and directed to designated individuals or departments.
  • Cultivated impactful relationships with customers and drove business development by delivering superior knowledge of health plans.
  • Assisted with locating physicians, urgent cares and hospital for members.
  • Updates member information to assist in their inquiries about health insurance.
  • Adapted to changes with in medical industry by keeping with changes with corporate continuous changes.
  • Worked effectively in fast-paced environments.
  • Worked well in a team setting, providing support and guidance.
  • Demonstrated respect, friendliness and willingness to help wherever needed.
  • Excellent communication skills, both verbal and written.
  • Passionate about learning and committed to continual improvement.
  • Strengthened communication skills through regular interactions with others.
  • Organized and detail-oriented with a strong work ethic.
  • Adaptable and proficient in learning new concepts quickly and efficiently.

Answering Service Operator

TeleDirect
03.2014 - 06.2015
  • Used PCP to log, manage, and record calls.
  • Transcribed and forwarded customer messages to various business and physician offices.
  • Maintained excellent customer satisfaction through polite, calm demeanor.
  • Fielded incoming calls, answered questions, and transferred calls internally.
  • Researched and quickly resolved customer issues.
  • Communicated general company information to inquiring customers in a professional and pleasant manner to project a positive company image.
  • Handled incoming calls with friendly and cheerful attitude for organization using numerous phone-line system.
  • Answered calls with friendly and polite approach to engage callers and deliver exceptional customer service.
  • Answered up to 40 calls per day in fast-paced environment, transferring callers to appropriate personnel.
  • Completed connections between callers, departments and professionals.
  • Managed corporate phone services for bustling business with numerous employees by routing calls quickly and accurately.
  • Paged employees over PA system to ensure prompt connection with callers.
  • Computed accurate sales prices for purchase transactions.
  • Logged all daily shipping and receiving orders.
  • Answered customers' questions and addressed problems and complaints in person and via phone.

CUSTOMER CONSULTANT I, II

GAP INC DIRECT
08.2009 - 01.2014

Created new processes and systems for increasing customer service satisfaction. Developed highly empathetic client relationships and earned reputation for exceeding sales goals. Computed accurate sales prices for purchase transactions. Prepared and sold broad range of customized merchandise to individuals and commercial accounts. Interacted with customers and retail buyers to follow-up on shipping statuses and expedited orders. Promptly responded to general inquiries from members, staff, and clients via mail, e-mail and fax. Accurately logged all daily shipping and receiving orders. Executed outbound calls to existing customer base resulting in 75 % increase in sales. Guaranteed positive customer experiences and resolved all customer complaints. Assisted customers with store and product complaints. Successfully interacted with customers and retail buyers to expedite orders.

HEALTH CARE SPECIALIST

CALPers
01.1995 - 10.1996

Assisted state employees with enrolling in health and dental care. Assisted with enrollment issues in health care. Resolved benefit issues and dependent coverage issue with state benefits. Assisted with open enrollment with State of CA health care coverage.

  • Managed and updated health records of all members personnel

Education

Associate of Arts - Business

American River College
Sacramento, CA

Some College (No Degree) - Office Technician

Lincoln LCC
Sacramento, CA

Certified Trained Phlebotomist - Phlebotomy

National Career Education
2004

Skills

  • Strong organizational skills
  • Active listening skills
  • Seasoned in conflict resolution
  • Sharp problem solver
  • Courteous demeanor
  • Energetic work attitude
  • Fashion knowledge
  • Opening/closing procedures
  • Telephone inquiries specialist
  • Customer service expert
  • Telecommunication skills
  • Adaptive team player
  • Visual merchandising proficiency
  • Inventory control familiarity
  • Energetic work attitude
  • Verifying Dates
  • Critical Thinking
  • Document Management and Storage
  • Workflow Processes
  • Records Storage
  • Updating Client Data
  • Data Review and Verification
  • Clerical Support
  • Children's medical needs
  • Medical record security
  • Medical Information Sharing
  • Medical histories
  • Medical record assessment
  • Medical transcription
  • Medical claims submission
  • Medical insurance knowledge

Affiliations

Licensed Insurance Sales Specialist with State of California 2008-09

Timeline

Medi-Cal Specilaist

XELA/ Gainwell Technologies
10.2022 - 04.2023

Customer Service Health Representative

Centene Corp.
08.2017 - 05.2022

Answering Service Operator

TeleDirect
03.2014 - 06.2015

CUSTOMER CONSULTANT I, II

GAP INC DIRECT
08.2009 - 01.2014

HEALTH CARE SPECIALIST

CALPers
01.1995 - 10.1996

Associate of Arts - Business

American River College

Some College (No Degree) - Office Technician

Lincoln LCC

Certified Trained Phlebotomist - Phlebotomy

National Career Education
Rachel Martinez