STEFANIE PANTOJA
San Antonio,TX
Summary
Highly proficient Senior Customer Service Representative with demonstrated customer service orientation and interpersonal and communication skills to effectively handle multiple tasks in fast-paced environment. Quality-focused producer consistently meets team and department production targets by delivering strong output to achieve metrics. Mentors new hires and existing staff in call handling best practices to promote accurate and consistent call responses.
Overview
19
19
years of professional experience
Work History
Senior Customer Service Representative-Remote
Optum Specialty Pharmacy-UHG
2022.11 - Current
- Inbound/Outbound calls- (i.e
- Benefit and eligibility, billing, payments & explanation of benefits (EOBs)
- Escalated calls, resolving more complex customer issues
- Identify the source of the caller’s issue, working to resolve the inquires in a timely manner
- Provide education and status on previously submitted pre-authorizations or pre-determination requests
- Intervene with care providers (doctor’s offices) on behalf of the customer
- Assist customers in navigating myuhc.com and other UnitedHealth Group/Optum websites while encouraging and reassuring them to becoming self-sufficient.
MEDICAL ASSISTANT FRONT OFFICE
Dr. Barbara Baxter, Allergy & Immunology Center
2005.12 - 2022.05
- Schedules clinical services, obtains current and accurate demographics and insurance information to register patient, verifies insurance coverage and eligibility via phone, fax, and/or on-line
- Obtains pre-certification from insurance companies, negotiates, and collects deposits and co-payment/co-insurance amounts
- Assuring correct billing information and minimizing the reimbursement risks associated with providing care to patients
- Flexibility and the ability to adapt in a busy atmosphere
- Strong customer service and communication skills
- Billing/Coding/Claims Processing/Payroll/Employee PTO
HUMAN RESOURCES MANAGER
W Dallas Victory Hotel & Residences
2006.06 - 2008.04
- Assist Director of HR in leading the development of department goals, objectives, and systems
- Work with managers and the HR team on continuous improvement of performance management measures for individuals and teams, ensuring best practice to meet the changing cultural needs
- Assist with projects contributing to the overall strategic development of HR
- Perform a variety of complex accounting functions in the preparation, processing of payroll/benefit records and payment of funds for office personnel; performs related duties as assigned.
Education
Certificate -
SANFORD BROWN INSTITUTE (SBI)
01.2005
Skills
- Remote Office Availability
- Customer Support
- Benefits Verification
- Special projects
- Claims Processing
- Billing & Coding
- Payroll Processing
- Complaint resolution
- Quality Assurance
- Escalation management
- Teamwork and Collaboration
- Multi-line phone talent
Timeline
Senior Customer Service Representative-Remote
Optum Specialty Pharmacy-UHG
2022.11 - Current
HUMAN RESOURCES MANAGER
W Dallas Victory Hotel & Residences
2006.06 - 2008.04
MEDICAL ASSISTANT FRONT OFFICE
Dr. Barbara Baxter, Allergy & Immunology Center
2005.12 - 2022.05
Certificate -
SANFORD BROWN INSTITUTE (SBI)
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