Rosana Barrancos

Analyzed and resolved high-volume patient, provider, and healthcare professional inquiries related to insurance claims, billing discrepancies, and provider network access, maintaining compliance with HIPAA regulations.

Managed and documented an average of 60+ inbound and outbound
calls daily, ensuring data integrity and confidentiality across
multiple healthcare databases (Epic, Salesforce, Power BI).

Identified trends in claim denials and coverage verification issues,
providing actionable feedback to improve process efficiency and
reduce repeat inquiries.

Educated patients on mental health benefits, coverage limitations,
and claims status, leveraging data insights to enhance understanding
and satisfaction.

Utilized real-time data tracking to monitor call resolution rates and
reduce average handling time while maintaining a high CSAT rating
and compliance standards.

Conducted root-cause analysis on escalated billing issues to drive
first-call resolution and improve overall operational performance.

Analyzed call center performance metrics (AHT, CSAT, FCR) to
identify operational bottlenecks and implement data-driven
strategies that improved overall efficiency and service delivery.
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Responded to real-time team support inquiries, maintaining optimal
queue performance and minimizing call handling delays.
•
Increased customer satisfaction scores by developing and executing
targeted performance improvement plans based on quality
assurance and feedback trend analysis.
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Conducted recurring training sessions informed by call analytics,
equipping 22 customer service agents with data-backed
communication and problem-solving techniques that improved firstcall resolution rates by 15%.

• Oversaw Medicare and Medicaid service operations—including claims, authorizations, and benefits inquiries—ensuring compliance with CMS
  and HIPAA standards through consistent auditing and documentation review.
  •
  Leveraged workforce management data to balance team workloads
  and maintain SLA adherence across multiple service channels.

• Monitored daily call center operations to ensure compliance with CMS regulations, HIPAA standards, and company policies.
• 
  Analyzed call metrics (AHT, CSAT, QA scores) and implemented
  strategies to meet or exceed service level agreements (SLAs)
• 
  Supervised and supported 26 customer service representatives handling
  Medicare-related inquiries, claims, enrollments, and policy issues.
• 
  Acted as an escalation point for complex or sensitive member and
  provider issues, ensuring timely and satisfactory resolutions.
• 
  Collaborated with management and cross-functional departments to streamline processes and communicate updates on Medicare policy
  changes.