Rebeca Reyes
Orlando
Summary
Detail-oriented claims professional with extensive experience in managing and processing claims across various industries. Skilled in evaluating claims for eligibility, calculating payments, and ensuring compliance with regulatory requirements. Expert at reviewing documentation, determining claim validity, and resolving complex issues with accuracy and efficiency. Strong analytical, organizational, and communication skills, with a proven ability to handle high-volume claims while maintaining compliance and exceeding performance standards.
Overview
7
7
years of professional experience
Work History
Leave of Absence Coordinator
Sedgwick
06.2023 - Current
- Manage FMLA and other leave claims, ensuring compliance with state and federal regulations.
- Analyze eligibility and approve/deny claims.
- Review medical documentation, determine leave duration, and ensure confidentiality.
- Collaborate with HR and employees to process leave requests efficiently.
- Maintain detailed records and provide timely updates to ensure smooth case handling.
- Deliver excellent customer service by addressing employee inquiries and resolving issues promptly.
- Coordinated leave of absence requests, ensuring compliance with company policies and legal regulations.
Customer Service Representative
Wyndham Destinations
08.2021 - 06.2023
- Addressed inquiries from owners, relatives, and attorneys regarding ownership changes and deed modifications.
- Efficiently processed requests, maintaining organization and meeting deadlines for ownership change requests.
- Resolved customer inquiries and issues through effective communication and problem-solving skills.
Patient Care Specialist
CVS Health
09.2020 - 08.2021
- Managed medication refills and prescription inquiries, supporting pharmacy operations and patient needs.
- Facilitated patient intake processes, ensuring accurate documentation and data entry.
- Coordinated with healthcare providers to obtain necessary approvals for medication refills and new prescriptions.
Reservation Agent
Wyndham Destinations
08.2019 - 03.2020
- Achieved Top Agent recognition for consistently booking 200+ reservations per month.
- Skilled at working independently and collaboratively in a team environment.
- Managed guest inquiries via phone and email, providing timely and effective solutions to enhance the experience.
- Managed customer inquiries and resolved issues efficiently to enhance satisfaction.
Call Center Representative
Encore Resort at Reunion
02.2018 - 08.2019
- Managed customer inquiries and resolved issues efficiently, enhancing overall satisfaction.
- Implemented process improvements that streamlined call handling, reducing wait times for clients.
- Handled escalated calls professionally, effectively resolving complex issues and ensuring client satisfaction at all times.
- Delivered consistent top-notch performance under pressure during peak calling hours or challenging situations.
- Handled inbound calls and chats to secure reservations for potential guests.
Education
High School Diploma -
Liberty High School
Skills
- Customer Service: 4 years in customer-facing roles
- FMLA and Leave Administration: 2 years of experience in managing claims and documentation
- Bilingual (Spanish/English): Fluent in both languages
- Technical Skills: Microsoft Office Suite (Word, Excel, PowerPoint, Outlook), ICD-10, Medicare, Live Chat, Insurance Verification
- Organizational Skills: Detail-oriented, with a strong ability to prioritize and manage workloads efficiently
- Typing Speed: 50 WPM
Timeline
Leave of Absence Coordinator
Sedgwick
06.2023 - Current
Customer Service Representative
Wyndham Destinations
08.2021 - 06.2023
Patient Care Specialist
CVS Health
09.2020 - 08.2021
Reservation Agent
Wyndham Destinations
08.2019 - 03.2020
Call Center Representative
Encore Resort at Reunion
02.2018 - 08.2019
High School Diploma -
Liberty High School
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