SHAHARA RODRIGUEZ

Assessed patient eligibility for financial assistance programs.

Supported patients with applications and required documentation.

Communicated with healthcare providers to verify prescriptions.

Maintained accurate records while adhering to HIPAA guidelines.

• Analyzed call center metrics such as average handle time and first contact resolution rate
• Educated customers about available coverage options so they can make informed decisions about their policies
• Implemented strategies designed to reduce wait times for callers seeking assistance from customer service representatives
• Coordinated with state pharmacy team for prescription issues on behalf of members
• Submitted referrals to our state premium office for Medicare members regarding premium assistance for QMB/SLMB/QI
• Handled escalated calls from dissatisfied customers in a professional manner
• Submitted referrals for medical services

• Company Overview: NJ Department of Health Vital Statistics Unit
• Utilized problem-solving techniques to quickly resolve customer issues while maintaining high levels of customer satisfaction
• Proficiently navigated multiple computer systems and applications to accurately process customer orders
• Developed strong communication skills, both written and verbal, in order to effectively respond to customer inquiries
• Assisted customers with billing problems or issues regarding account status
• Assisted members on how to obtain birth, death and marriage records
• Provided status on orders placed through our state system
• Assisted with corrections on vital records per the request of members
• NJ Department of Health Vital Statistics Unit

• Company Overview: Blue Cross Blue Shield
• Assessed potential risks associated with new business opportunities related to managed care contracts
• Performed regular reviews of member eligibility status for managed care plans
• Facilitated communication between internal departments such as billing, coding, clinical services, legal affairs
• Coordinated with pharmacy team regarding prescription issues on behalf of members
• Blue Cross Blue Shield

• Company Overview: State of NJ Office of Public Guardian
• Assisted with scheduling appointments and maintaining calendars for attorneys as well as our state public guardian
• Answered incoming calls and emails promptly and professionally
• Performed administrative tasks such as filing, copying, scanning documents, data entry, and mail distribution
• Assisted nurse case management with member's information for referrals for medical services
• State of NJ Office of Public Guardian