Yaquelin Ruiz Pizano

Member Service Representative I June 2022-May 2023

Member Service Representative II May 2023-October 2023

Member Service Representative III October 2023-Current

• Deliver the company's 5-star promise by efficiently answering members' requests and questions.
• Adhere to verification and security procedures when discussing account information with members or third parties, and ensure all information is kept confidential and secure.
• Provided input into developing new processes for improving member service and representative experience.
• Provided leadership, guidance and mentoring to team members.
• Utilized de-escalation techniques during high-stress situations

• Reviewed and corrected claim errors to facilitate smooth processing.
• Responded to customer concerns and questions, resulting in the handling of over 55 inbound and outbound calls.
• Executed billing tasks and recorded information in the company database.
• Informed patients about payment options, billing policies, and procedures related to their visit or procedure.
• Reviewed patient accounts for accuracy on a regular basis.
• Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
• Obtained insurance verification and authorization to submit financial clearance of patient accounts.
• Verified insurance information and collected payments.

• Kept records of pickups and deliveries by obtaining necessary signatures and receipts.
• Provided accurate information about products, prices and services.
• Processed transactions using a point-of-sale system.
• Built relationships with customers to encourage repeat business.
• Restocked shelves as needed to ensure sufficient inventory levels.
• Handled customer complaints in a professional manner.
• Suggested ideas for improving store operations and increasing profits.
• Maintained cleanliness of store environment including floors, windows, displays.
• Helped customers find specific products, answered questions and offered product advice.

• Displayed positive, professional conduct to interact with staff, patients, and visitors.
• Assisted in the preparation and delivery of meals to patients according to dietary requirements.
• Maintained accurate records of patient diets and nutrition services provided.
• Collaborated with staff members to ensure efficient operation of nutrition services department.
• Adhered to all sanitation policies while preparing meals in the kitchen area.
• Performed daily maintenance tasks such as cleaning floors, walls and counters in order to maintain a clean working environment.
• Assembled prepared food on trays for patients with regular and modified diets.