Shirley Hidalgo
UniVista Insurance
Miami Gardens,FL
12
Years of experience
Detail-oriented Customer Service Specialist with expertise in guiding members through health plan benefits and services. Skilled in resolving claims, billing, eligibility, and coverage issues while ensuring compliance with HIPAA guidelines. Committed to safeguarding member information and maintaining precise documentation to foster a supportive and respectful environment.
Work History
Member Service Representative
1 Year 5 Months- Provided exceptional customer service by assisting members with questions and concerns regarding health plan benefits, claims, and coverage while ensuring a positive and supportive experience.
- Assisted members with understanding claims, billing inquiries, and eligibility requirements by providing clear explanations and guidance to help reduce confusion and improve member satisfaction.
- Educated members on available plan benefits and resources, including healthy living programs, transportation assistance, and specialized services such as Papa Pals, helping members understand and access the services available to them.
- Resolved member concerns promptly while adhering to company policies and HIPAA regulations, fostering trust and satisfaction.
- Collaborated with internal departments to escalate complex issues and ensure timely resolutions for members.
- Maintained up-to-date knowledge of health plan benefits and policy changes to provide accurate support and enhance member experience.
- Accurately documented member interactions in the system, including approval details, reference numbers, case notes, and status updates to maintain complete and organized records.
Courier
10 Years 4 Months- Professional Summary
- Dedicated and reliable FedEx Express Cover Driver with 10 years of experience (since April 2014) supporting delivery operations across the Bronx and Manhattan. Proven ability to efficiently cover multiple routes while maintaining accuracy, timeliness, and strong organizational standards.
- Demonstrated key strengths in delivery operationsCovered diverse delivery routes, ensuring timely and accurate deliveries
- Demonstrated strong time management and organizational skills by efficiently coordinating delivery schedules
- Exhibited dependability and efficiency while managing high-pressure situations
- Maintained high performance in fast-paced logistics environments, contributing to overall operational success
- Team-focused with a strong work ethic and commitment to reliability
Education
GED - High School
Skills
Health plan benefits
Claims processing
Eligibility verification
HIPAA compliance
Case documentation
Records management
Time management
Member relations
Issue escalation
Service recovery
Clear communication
Attention to detail
LANGUAGES
English: Professional, Spanish: Professional
Timeline
Member Service Representative
UniVista Insurance
01.2025 - 06.2026Read More
Courier
Federal Express
04.2014 - 08.2024Read More
La Guardia Community College
GED from High School
01.2009 - 05.2009Read More