Sierra Gomez
Greenville,SC
Summary
Experienced and versatile professional with a strong background as a;Customer Service Representative , Insurance Verification Specialist, and Technical Support Specialist. Possesses exceptional communication, problem solving, interpersonal skills to efficiently handle high volume call environment and maintain strong client relationships. Proficient in utilizing various CRM, insurance claim management, and technical support systems.
Overview
10
10
years of professional experience
Work History
Customer Service Representative
Health Plan One
06.2025 - 03.2026
- Conduct a thorough needs analysis with each client and determine the most appropriate insurance plan based on a combination of price and value from the carriers represented
- Assist clients in the application process and ensure that all required information is accurate and compliant with all applicable rules and regulations
- Submit complete applications in a timely manner
- Understand and adhere to all company, carrier and/or CMS related policies and procedures
- Comprehend and clearly articulate product knowledge
- Identify and assess customer's needs to achieve satisfaction
- Manage high volume of incoming calls
- Meet established production goals
- Handle complaints, provide appropriate solutions and alternatives within the time limits; follow up to ensure resolution
- Perform other related job duties as required
Pharmacy Technician
CVS
Rockhill
02.2016 - 04.2018
- Managing inventory
- Scheduling patient's prescriptions to be filled measuring medication.
- Completing transactions using cash register.
- Filling prescriptions.
Customer Service Representative
Iron Insights
12.2024 - 05.2025
- Answer phone professionally and expeditiously – speaking with patients, insurance companies and pharmacies.
- Respond to customer inquiries in a timely manner
- Review customer insurance plan(s) to assist in patient assistance program (PAP)
- Research required information using available resources
- Handle and resolve customer complaints
- Provide customers with product and service information
- Identify and escalate priority issues
- Route calls to appropriate resource
- Maintain excellent notes in appropriate systems
- Help to maintain required project documentation
- Other tasks, as assigned
Sales Support Service Representative
Ehealth
09.2024 - 12.2024
- Handle a high volume of inbound customer phone calls daily.
- Adhere to attendance and conformance standards, based on internal policies.
- Adhere to script, compliance, and legal processes in place to protect employees and beneficiaries.
- Adhere to internal transfer processes provided by management.
- Ability to receive and apply feedback to improve performance. Demonstrate a consistent positive attitude and a customer centric approach to deliver a superior experience.
- Gather key information from customers to assist in transferring to the correct department.
- Actively listen to the customers' inquiries and document their concerns.
- Handle initial objections and provide expectations on how to resolve.
- Help customers navigate the web site.
- Educate customers on eHealthInsurance and how we can benefit them.
- Document detailed information while on the phone with the members. Meet additional standards established by Sales Management.
- Meet monthly goals
Front Desk Receptionist
Retina Consultants
12.2023 - 06.2024
- Check patients/ check patients out.
- Verify patient information and update patient's chart Provide/ collect patient balance.
- Scheduling, cancel, reschedule appointments.
- Perform admin duties.
- Keep a clean work station.
Patient Service Representative
Village Medical
12.2022 - 12.2023
- Register patients
- Assist patients by answering inbound calls.
- Transferring patients to the proper location
- Scheduling, rescheduling, and canceling appointments.
- Verify HIPAA
- Send messages through EMR.
- Assist patients with patient portal.
- Provide great customer service, and use active listening skills.
Patient Service Representative
Privia Health
08.2021 - 08.2022
- Verifying HIPAA
- Received inbound and outbound calls
- Explain explanation of benefits
- Providing patients with multiple payment options resubmitting bill to insurance.
- Reset passwords
Customer Service Representative
Meduit
04.2018 - 08.2021
- Verifying HIPAA
- Provide patients with multiple payment options.
- Answering patients questions about billing statements resubmitting bills to insurance.
- Explaining explanation of benefits to patients
Education
High school diploma -
Colleton County High School
05-2010
Skills
- Problem-solving skills
- Team collaboration
- Confidentiality and HIPAA
- Workflow optimization
- Answering customer questions
- Insurance billing
- Medication dispensing
- Patient confidentiality
- Prescription filling
- Insurance verification
- Pharmacy ethics
- HIPAA
- Pharmacy and customer records management
- Drug inventory control
- Labeling accuracy
- Drug safety
- Pharmaceutical calculations
- Stocking shelves
- Processing payments
- Pharmacy software proficiency
- Interpreting and processing medication orders
- Pharmacy law compliance
- Healthcare regulations
- Medication labels
- Medicare and medicaid process
- Drug inventory management
- Prescription interpretation
- Verifying orders
- Advanced math skills
- Manual and automated medication dispensing
- Compounding techniques
- Medication storage procedures
- Regulatory compliance
- Secure storage of medications
- Drug interaction awareness
- Updating medication histories
- Dosage form preparation
- Drug storage procedures
- Interpreting orders
- Aseptic techniques
- FDA drug safety guidelines
- Quality assurance and control
- Proper labeling
- FDA and HIPAA compliance
- Resolving customer issues
- Proper labeling procedures
- Pharmacy operations
- FDA compliance
- Labeling prescriptions
- Customer service
- Data entry
- Attention to detail
- HIPAA compliance
- Prioritization and organization
- Prescription filling and labeling
- Dispensing medications
- Cash register operations
- Team coordination
- Insurance processing
- Inventory tracking
- Creative thinking
- Analytical thinking
- Relationship building
- Patient profile setup
- Resolving complaints
- Medication storage and labeling
- Payment processing
- Prescription refill fulfillment
- Medication documentation
Timeline
Customer Service Representative
Health Plan One
06.2025 - 03.2026
Customer Service Representative
Iron Insights
12.2024 - 05.2025
Sales Support Service Representative
Ehealth
09.2024 - 12.2024
Front Desk Receptionist
Retina Consultants
12.2023 - 06.2024
Patient Service Representative
Village Medical
12.2022 - 12.2023
Patient Service Representative
Privia Health
08.2021 - 08.2022
Customer Service Representative
Meduit
04.2018 - 08.2021
Pharmacy Technician
CVS
02.2016 - 04.2018
High school diploma -
Colleton County High School