Rosa Herrera
Sacramento,CA
Summary
Customer Service Representative with HealthNet Federal Services, skilled in bilingual communication and conflict resolution. Successfully managed high-volume call handling, ensuring compliance, and customer satisfaction. Proficient in data entry and payment processing, consistently identifying customer needs, and enhancing service quality through effective teamwork and problem-solving abilities.
Overview
20
20
years of professional experience
Work History
Customer Service Representative
HealthNet Federal Services
Sacramento, California
08.2004 - 01.2025
- Provided high-quality customer service support to beneficiaries of the Department of Defense TRICARE program, under Health Net Federal Services.
- Responded to inbound calls, emails, and written correspondence from beneficiaries, healthcare providers, and military personnel regarding eligibility, benefits, claims status, referrals, and authorizations.
- Maintained a strong working knowledge of TRICARE policies, federal regulations, and HNFS procedures to ensure accurate information and support.
- Utilized internal systems, such as call tracking software and member databases, to document customer interactions and track issue resolution.
- Escalated complex or unresolved inquiries to appropriate departments, ensuring timely and effective follow-up.
- Met or exceeded performance standards in call quality, customer satisfaction, and resolution rates.
- Handled sensitive personal health information (PHI) in compliance with HIPAA, and other federal privacy regulations.
- Assisted in special projects, system testing, or policy updates related to process improvements and quality assurance.
- Processed payments quickly and accurately, maintaining data integrity, and ensuring customer satisfaction.
Education
High School Diploma -
San Fernando High School
Los Angeles, CA05-1987
Skills
- Bilingual communication
- Data entry
- Payment processing
- Customer relationship management
- Compliance management
- Inbound call handling
- Conflict resolution
- Organizational skills
- Effective communication
- Time management
- Problem solving
- Team collaboration
- Quality assurance
- Customer service
- TRICARE knowledge
- HIPAA compliance
- Call center operations
- Federal healthcare systems
- Communication
Timeline
Customer Service Representative
HealthNet Federal Services
08.2004 - 01.2025
High School Diploma -
San Fernando High School
Similar Profiles
Helen SeatonHelen Seaton
Intake Representative at HealthNet Federal ServicesIntake Representative at HealthNet Federal Services
Megan MorrowMegan Morrow
Medical Claims Associate at HealthNet Federal ServicesMedical Claims Associate at HealthNet Federal Services
Jori ClarkJori Clark
Intake Representative I at Healthnet Federal ServicesIntake Representative I at Healthnet Federal Services
Jori ClarkJori Clark
Intake Representative I at Healthnet Federal ServicesIntake Representative I at Healthnet Federal Services
Kyle AndersonKyle Anderson
Warehouse Associate at Lineage Logistics LLCWarehouse Associate at Lineage Logistics LLC