Shanice Contreras
Teleperformance
Brownsville,TX
12
years of professional experience
Dedicated customer service professional with 5+ years of experience in healthcare, banking, and retail environments. Skilled in HIPAA compliant member support, claims processing, cash handling, account services, and resolving complex inquiries with accuracy and empathy. Proven ability to manage high call volumes, de-escalate concerns, and maintain compliance while delivering quality service. Adaptable team player with strong attention to detail and problem solving skills.
Work History
Customer Service Representative
4 Months- Maintained HIPAA compliance while coordinating healthcare access for members, including scheduling appointments with doctors, specialists, and dentists
- Safeguarded protected health information when processing ID card orders, updating accounts, and arranging member transportation services
- Educated members on covered benefits and eligibility, ensuring all communications adhered to HIPAA privacy standards
- Managed sensitive cases including appeals and grievances, using de-escalation techniques while protecting member confidentiality
- Verified provider credentials and located in-network doctors, specialists, and dentists to support member care needs
Personal Banker
3 Months- Opened and serviced consumer banking products including checking accounts, savings accounts, and CDs, tailoring solutions to client financial goals
- Processed daily transactions including deposits, withdrawals, and cash handling with 100% balancing accuracy and adherence to Bank Secrecy Act guidelines
- Supported loan origination by assisting clients with applications, gathering documentation, and explaining loan terms and requirements
- Drove revenue growth through cross-selling bank products and services, identifying client needs during account openings and transactions
- Maintained compliance with federal regulations and internal policies while safeguarding customer information and preventing fraud
Customer Service Advocate
11 Months- Resolved pharmacy benefit issues for members by reprocessing rejected claims and coordinating prescription refills to ensure timely medication access
- Liaised with pharmacies to override rejections and reprocess claims, reducing delays in care and improving member satisfaction
- Maintained HIPAA compliance while accessing and discussing protected health information across member accounts and pharmacy systems
- Troubleshot claim denials by analyzing rejection codes, verifying eligibility, and applying appropriate overrides per plan guidelines
- De-escalated member concerns regarding prescriptions and benefits, providing clear explanations of coverage and next steps
Auto Detailer
5 Months- Performed full-service vehicle detailing including exterior washes, waxing, and interior vacuuming to meet quality and appearance standards
- Maintained workflow efficiency by completing X vehicles per shift while ensuring attention to detail and customer satisfaction
- Operated detailing equipment and applied cleaning products safely, following company procedures and safety guidelines
- Inspected vehicles pre and post-service to identify areas needing extra attention and ensure quality control standards
Customer Service Represenative
2 Months- Guided members in locating in-network doctors, hospitals, pharmacies, and specialists using provider directories and plan tools
- Explained benefits and coverage to members, breaking down complex insurance terms into clear, HIPAA-compliant guidance
- Fulfilled member requests including ID card orders and account updates while safeguarding protected health information
- Resolved inquiries regarding eligibility, claims, and network status, contributing to member retention and satisfaction
- Navigated multiple systems to verify provider participation and ensure accurate information during each call
Sales Associate
2 Months- Operated POS system and managed cash handling duties including sales transactions, returns, and daily drawer reconciliation with 100% accuracy
- Maintained visual merchandising standards by stocking inventory, pricing items, and organizing sales floor to drive product visibility
- Produced custom merchandise by heat-pressing t-shirts per customer orders while ensuring quality and design accuracy
- Delivered customer service on the sales floor, assisting shoppers with sizing, product details, and purchase decisions to increase sales
- Supported inventory control through restocking, cycle counts, and monitoring product levels to prevent stockouts
Sales Associate
2 Years 2 Months- Operated POS system and managed cash handling duties including sales transactions, returns, and daily drawer reconciliation with 100% accuracy
- Maintained visual merchandising standards by stocking inventory, pricing items, and organizing sales floor to drive product visibility
- Produced custom merchandise by heat-pressing t-shirts per customer orders while ensuring quality and design accuracy
- Delivered customer service on the sales floor, assisting shoppers with sizing, product details, and purchase decisions to increase sales
- Supported inventory control through restocking, cycle counts, and monitoring product levels to prevent stockouts
Education
High School Diploma
Skills
De-escalation & Conflict Resolution
Active Listening
Member/Client Education
First-Call Resolution
Multi-channel Support: phone
chat
in-person
HIPAA Compliance
Pharmacy Benefit Support
Claims Processing & Overrides
Provider Network Navigation
Explanation of Benefits (EOB)
Appeals & Grievances
Cash Handling & Drawer Balancing
Account Opening: checking
savings
CDs
Loan Application Support
BSA/AML Awareness
Cross-Selling & Needs-Based Selling
Fraud Prevention
CRM Systems: Salesforce
Care Connect
POS Systems & Transaction Processing
Inventory Management & Stocking
Data Entry & Account Updates
Microsoft Office: Word
Excel
Outlook
Quality Assurance Standards
Attention to Detail
Time Management in High-Volume Settings
Multitasking & Prioritization
Problem Solving
Bilingual: English/Spanish
Timeline
Customer Service Representative
Teleperformance
09.2025 - 01.2026Read More
Personal Banker
First Convenience Bank
12.2024 - 03.2025Read More
Customer Service Advocate
TTEC
09.2022 - 08.2023Read More
Auto Detailer
Uniseal
04.2022 - 09.2022Read More
Customer Service Represenative
Results Cx
01.2022 - 03.2022Read More
Sales Associate
Beach Club
06.2020 - 08.2020Read More
Sales Associate
Oxygen Gift Shop
02.2014 - 04.2016Read More
South Texas Leadership Center
High School Diploma
Read More