Summary
Overview
Work History
Education
Skills
Certification
Languages
Timeline
Generic

Rosa Maria Lopez

Brighton,CO

Summary

Offering positive, detail-oriented approach with dedication to learning and growing in healthcare environment. Contributes ability to quickly grasp insurance processes and efficiently manage documentation. Ready to use and develop communication and organizational skills in Clinical Setting and Collections Department

Overview

10
10
years of professional experience
1
1
Certification

Work History

Prior Authorization Representative

CVScaremark
04.2021 - 12.2024
  • Manage up to 80 calls per day from Dr's and Members
  • Managed up to 50 faxes per prior Auth
  • Provided exceptional customer service, addressing inquiries from both patients and healthcare providers promptly and professionally.
  • Verified eligibility and compliance with authorization requirements for service providers.
  • Ensured compliance with HIPAA regulations by maintaining strict confidentiality in handling sensitive patient information.
  • Processed new medication and refill requests for authorization.
  • Communicated pertinent information to client's prescribing provider to facilitate quality service.
  • Improved patient satisfaction by efficiently processing prior authorization requests and ensuring timely responses.

Pharmacy Technician Advisor

CVS Health
04.2019 - 04.2024
  • Talk to members that need their prescriptions refilled Call Pharmacy and get medication filled for the members
  • Assisted customers promptly, addressing inquiries and resolving issues with professionalism.
  • Provided prompt assistance to healthcare providers, fostering positive relationships between pharmacies and medical teams.
  • Collaborated with pharmacists to ensure smooth workflow, enabling timely processing of prescriptions.
  • Optimized workflow through effective prioritization and multitasking in high-volume settings.
  • Safeguarded patient privacy by strictly adhering to HIPAA guidelines at all times during processing transactions or consultations.

Customer Service Representative

MAXIMUS FEDERAL SERVICE
09.2018 - 03.2019
  • Take incoming calls from consumer that are enrolling in the Obama Health Care.I assist the consumer with the application and help pick a health plan that best fits there needs.
  • Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
  • Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
  • Responded to customer requests for products, services, and company information.
  • Developed strong product knowledge to provide informed recommendations based on individual customer needs.
  • Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
  • Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
  • Assisted customers in navigating company website and placing online orders, improving overall user experience.
  • Contributed to sales growth by up selling products and services based on individual customer requirements.
  • Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.

College America
12.2016 - 06.2018

Attended College America in Phoenix Az and was in class 4-6 hrs a day, Obtained a certification for Associate of Studies medical Specialties. Did some intern work as medical Bill collector and in the collections dept.

  • Excellent communication skills, both verbal and written.
  • Self-motivated, with a strong sense of personal responsibility.
  • Worked effectively in fast-paced environments.
  • Skilled at working independently and collaboratively in a team environment.
  • Proven ability to learn quickly and adapt to new situations.
  • Demonstrated respect, friendliness and willingness to help wherever needed.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.
  • Passionate about learning and committed to continual improvement.
  • Managed time efficiently in order to complete all tasks within deadlines.
  • Organized and detail-oriented with a strong work ethic.
  • Paid attention to detail while completing assignments.
  • Strengthened communication skills through regular interactions with others.
  • Learned and adapted quickly to new technology and software applications.

C.S.R

Randstad Temp
04.2016 - 05.2016
  • Working in a call center taking calls from customer that there accounts were being levy or money put on hold for Wells Fargo
  • Reduced foreclosure timelines by efficiently managing case files and ensuring timely completion of necessary tasks.
  • Facilitated negotiations between lenders and borrowers, resulting in mutually beneficial resolutions for both parties.
  • Contributed to departmental goals by consistently meeting or exceeding performance targets for case closures and client satisfaction ratings.
  • Maintained detailed records of all correspondence, documentation, and actions taken during the course of each foreclosure case.
  • Reviewed loan and foreclosure documents and verified for accuracy.
  • Evaluated foreclosure litigation paperwork, affidavits, and post-sale documents.
  • Provided guidance on loan modification options available for borrowers facing financial hardship.
  • Administered property foreclosures, encompassing proper and timely assignation of cases to realtors.

Water Distribution Operator

About People Temp Service
12.2015 - 04.2016
  • Communicated with customers daily in the water department
  • Communicated information clearly and accurately
  • Committed to the assistance and support of others while maintaining a cheerful and helpful attitude
  • Built rapport with customers through effective and precise communication
  • Researched accounts, answered questions, and worked with new customers
  • Developed credibility and confidence with customers Analyzed problems and anticipated customers' needs
  • Handled customer inquiries and complaints
  • Trained in providing world-class customer service
  • Responded to inbound service calls in a fast-paced, high-volume call center.

Concierge

Urban lending Solutions
09.2014 - 05.2015
  • Answers inbound phone calls from customers when the assigned Customer relationship manager (CRM) is not available
  • Concierge Associates will use client systems to answer customer questions pertaining to their account and /or schedule callback times for the CRM, that are convenient for the customer
  • Process and research payments confirm documents receipt and inform customers of any additional documents needs
  • Explain escrow calls to appropriate amounts and reasons for payments increase
  • Skills Used Mortgage and do modifications on home loans
  • Accomplishments experience in Loan modifications

Education

Associate of Applied Science - Associate of Occupational Studies Medical Special

College America
Phoenix, AZ
07-2018

Skills

  • Pharmacy advisor
  • Customer service
  • Problem-solving
  • Call center experience
  • Research
  • Insurance Verification
  • HIPAA Compliance
  • Medical terminology knowledge
  • Patient insurance authorizations
  • Electronic Records Management
  • Knowledgeable in Word & Excell
  • Data Entry
  • Records Maintenance
  • Billing Procedures
  • Basic medical terminology
  • Benefit coverage
  • Patient scheduling
  • Electronic refill request processing

Certification

  • Microsoft Office Specialist (MOS) - Microsoft.
  • Customer Service Representative (CSR) Certificate – HDI or Similar Organizations.
  • Advanced Excel Course Certificate – Various Online Platforms like Udemy, Course's.
  • Basic Life Support (BLS) – American Heart Association.
  • Colorado Driver's License


Languages

Spanish
Native or Bilingual

Timeline

Prior Authorization Representative

CVScaremark
04.2021 - 12.2024

Pharmacy Technician Advisor

CVS Health
04.2019 - 04.2024

Customer Service Representative

MAXIMUS FEDERAL SERVICE
09.2018 - 03.2019

College America
12.2016 - 06.2018

C.S.R

Randstad Temp
04.2016 - 05.2016

Water Distribution Operator

About People Temp Service
12.2015 - 04.2016

Concierge

Urban lending Solutions
09.2014 - 05.2015

Associate of Applied Science - Associate of Occupational Studies Medical Special

College America
  • Microsoft Office Specialist (MOS) - Microsoft.
  • Customer Service Representative (CSR) Certificate – HDI or Similar Organizations.
  • Advanced Excel Course Certificate – Various Online Platforms like Udemy, Course's.
  • Basic Life Support (BLS) – American Heart Association.
  • Colorado Driver's License


Rosa Maria Lopez