SERGIO ROBLES
San Antonio,TX
Summary
Customer focused, quality-driven customer service professional with over twenty years of experience in fast paced work environments. Possess polished ability to resolve customer needs and requirements. Skilled in problem solving practices with a proven track record of meeting and exceeding metric expectations. Focus in building broad leadership experience for maximum results.
Overview
25
25
years of professional experience
Work History
Insurance Verification Representative
Accenture
San Antonio, TX
03.2024 - Current
- Verify patient eligibility and benefits for insurance coverage.
- Research insurance plans to determine coverages and benefits available.
- Perform outbound calls to verify patient's insurance coverage status.
- Maintain accurate records of patient data in the system.
- Entered all pertinent data into computer systems accurately and efficiently.
- Access to third-party insurance databases to identify coverage of benefits.
- Interpret complex benefit plans according to provider contracts.
- Adhere to HIPAA guidelines when handling confidential information.
Insurance Verification Specialist
Medtronic
San Antonio, TX
04.2012 - 10.2023
- Ensured accurate selection of insurance policies and their associated claims addresses
- Confirmed insurance benefits and verified customer eligibility by gathering deductibles, coinsurance rates, authorizations, and out-of-pocket expenses
- Obtained crucial benefit and eligibility information using various online platforms.
- Processed orders for insulin pumps, continuous glucose monitors, sensors, and diabetes testing supplies
- Meet quotas of insurance verifications and eligibilities.
- Collaborated with internal staff members such as Billing Specialists, Medical Coders to resolve any discrepancies in patients' insurance information.
Order Processing Specialist
Medtronic
San Antonio, TX
02.2012 - 04.2012
- Processed orders for delivery of equipment and supplies to patients after full verification of benefits and eligibility had been conducted
- Faxed out authorizations to utilization management, medical groups and prior authorization departments
- Faxed out prescriptions to physicians for a year supply
- Emailed and faxed coordination of benefits to customers to enable us to process order in a timely manner
- Followed up on all documents to process order.
Technical Support Representative
Kinetic Concepts Inc.
San Antonio, TX
02.2008 - 11.2011
- Accountable for assisting clinicians, patients, and internal representatives in troubleshooting the vast array of products that we offered
- Provided technical support and customer service to all callers in regards to our products and services and problem solved for customer satisfaction and business retention
- Performed other duties such as creating service work orders and checking on warranty, non warranty, and customer owned products to assist their needs
- Specialized in setting up courier delivery for our products and supplies by using different systems.
Customer Service Representative II
Kinetic Concepts Inc.
San Antonio, TX
09.2005 - 02.2008
- Provided support and issue resolution for inbound callers
- Supported supervisors as needed during additional departmental and team needs
- Implemented updated processes, procedures, and programs in order to provide outstanding customer service
- Assisted callers in creating initial delivery orders for our products and supplies and problem solved for customer satisfaction and business retention
- Created relationships between facility accounts and medical insurance companies
- Checked for eligibility of benefits on patients and assisted private pay for patients with billing.
Senior Consultant
SBC
San Antonio, TX
01.2000 - 08.2005
- Served as a representative that would regain customers that had left our phone service, commonly referred to a winback campaign
- Delivered superior customer support to existing customers.
- Provided additional telephone services and resolved assorted problems
- Contacted and established service accounts with previous customers who agreed to return to our phone service
- Served current customers by selling a range of products including high-speed internet, wireless phone service, and satellite television
- Attended to the needs of Spanish speaking customers.
Education
Del Rio High School
Business Administration And Management
Southwest Texas Junior College
Del Rio, TXBusiness Administration and Management
San Antonio College
San Antonio, TXBusiness Administration and Management
Univeristy of The Incarnate Word
San Antonio, TXBusiness Administration and Management
Northwest Vista College
San Antonio, TXSkills
- Follow-up skills
- Insurance knowledge
- Accuracy and Precision
- Confidentiality
- HIPAA Compliance
- Claims Processing
- Microsoft Office
- Coverage and Authorizations
- Data Security and Confidentiality
- Secure data practices
- Insurance plan verification
- Understanding of medical terms
- Analytical Thinking
- Insurance terminology
- Data Entry and Review
- Customer Service
- Eligibility Determination
- Insurance Coverage Verification
- Document Management
- Electronic authorization processing
Timeline
Insurance Verification Representative
Accenture
03.2024 - Current
Insurance Verification Specialist
Medtronic
04.2012 - 10.2023
Order Processing Specialist
Medtronic
02.2012 - 04.2012
Technical Support Representative
Kinetic Concepts Inc.
02.2008 - 11.2011
Customer Service Representative II
Kinetic Concepts Inc.
09.2005 - 02.2008
Senior Consultant
SBC
01.2000 - 08.2005
Del Rio High School
Business Administration And Management
Southwest Texas Junior College
Business Administration and Management
San Antonio College
Business Administration and Management
Univeristy of The Incarnate Word
Business Administration and Management
Northwest Vista College