Ramon Reynoso
Glendale,AZ
Summary
Proven track record of enhancing eligibility determination accuracy and client satisfaction at Cigna, showcasing expert research abilities and effective communication. Innovated process optimizations and trained teams, demonstrating a blend of analytical prowess and interpersonal skills. Achieved significant improvements in service delivery and client relations without exceeding a numerical percentage.
Overview
11
11
years of professional experience
Work History
Eligibility Analyst Sr Associate
Cigna
03.2014 - 05.2018
- Increased accuracy of eligibility determinations with thorough documentation review and verification.
- Assisted management with staff training initiatives, sharing expertise on eligibility analysis techniques to improve overall team proficiency.
- Contributed to process improvements by identifying inefficiencies within the workflow and suggesting actionable solutions for optimization.
- Consistently maintained strong relationships with clients, ensuring clear communication and timely updates on project progress.
- Trained and supported new team members, maintaining culture of collaboration.
- Drafted common document templates to reduce time spent creating documents from scratch.
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Completed daily logs for management review.
- Served as liaison, facilitating communication between management and associates.
- Demonstrated flexibility by adapting quickly to changes in policies, procedures, or software tools, ensuring seamless service delivery.
- Ensure accurate and timely processing of paper enrollments, membership reports and qualifying life events.
- Develop "subject matter expertise" level of understanding regarding business rules, processes and system functionality.
- High degree of analytical accuracy required in order to be successful in this role. Must anticipate potential errors and or process disconnects before they occur.
- Acted as a communication sounding board for Client facing issues or pain points.
- Resolved discrepancies with client applications to verify eligibility.
Customer Service Rep Sr Associate
Cigna HealthCare
04.2007 - 03.2014
- Handled customer inquiries and suggestions courteously and professionally.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Updated account information to maintain customer records.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Work closely with Client Managers and Account Set-up unit to enure both groups and individual members are accurately setup in Oasis and PowerStepp systems.
- Work with matrix partners across the organization to drive optimal performance results and timely customer resolutions.
- Provide support to team members in balancing work load distribution and providing back up support.
Education
Associate of Science - Fire Science
Glendale Community College
Glendale, AZ05.2008
No Degree - EMT-Basic
Glendale Community College
Glendale, AZ05.2006
Skills
- Verbal Communication
- Research abilities
- Policy Interpretation
- Effective communication skills
Languages
Spanish
Professional Working
Timeline
Eligibility Analyst Sr Associate
Cigna
03.2014 - 05.2018
Customer Service Rep Sr Associate
Cigna HealthCare
04.2007 - 03.2014
Associate of Science - Fire Science
Glendale Community College
No Degree - EMT-Basic
Glendale Community College
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