SUHEY RIOS
Santa Clarita,CA
Summary
Dedicated healthcare professional with extensive experience in customer service, insurance verification, scheduling, and patient communication. Committed to delivering exceptional patient experiences while effectively supporting clinical teams. Bilingual in English and Spanish, with a proven track record of building trust and maintaining accurate patient records to enhance overall care quality. Expertise in fostering positive relationships ensures a compassionate approach to patient interactions and operational efficiency.
Overview
11
11
years of professional experience
1
1
Certification
Work History
Provider Service Representative
Anthem Inc. (Elevance Health)
12.2023 - 02.2026
- Served as primary contact for providers regarding claims, eligibility, and benefits.
- Verified insurance coverage and explained policies clearly and accurately.
- Resolved inquiries efficiently while maintaining high customer satisfaction.
- Documented all interactions in compliance with HIPAA regulations.
- Managed high call volumes while maintaining accuracy and professionalism.
Case Manager I
Health Advocates
06.2023 - 11.2023
- Verified patient insurance eligibility and coordinated benefits.
- Communicated with patients and insurance providers to gather required information.
- Maintained accurate patient records and documentation.
- Provided compassionate support to patients navigating healthcare services.
Crew Member
Trader Joe’s
09.2014 - 06.2023
- Delivered exceptional customer service in a fast-paced environment.
- Handled transactions, resolved customer concerns, and built positive relationships.
- Trained new team members on customer service and operations.
- Demonstrated strong teamwork, communication, and multitasking skills.
Education
Bachelor of Science - Health Information Management
DeVry University
Naperville, IL07-2026
Certificate - Medical Billing & Coding
DeVry University
Naperville, IL08-2023
Skills
- Interpersonal skills
- Independent
- Patient-focused with strong listening skills
- Efficient multi-tasker
- Proactive team member
- Friendly & compassionate
- Appointment scheduling management
- Insurance verifications & prior authorizations
- Maintain patient records & manage patient charts
- Customer service expertise across multiple channels
- Compassion and empathy for our patients
- Proactive learner
Certification
medical billing and coding
Languages
English
Native or Bilingual
Spanish
Native or Bilingual
Timeline
Provider Service Representative
Anthem Inc. (Elevance Health)
12.2023 - 02.2026
Case Manager I
Health Advocates
06.2023 - 11.2023
Crew Member
Trader Joe’s
09.2014 - 06.2023
Bachelor of Science - Health Information Management
DeVry University
Certificate - Medical Billing & Coding
DeVry University
ADDITIONAL QUALIFICATIONS
- Knowledge of ICD-10, CPT, and healthcare documentation
- Proficient in Microsoft Office (Word, Excel, Outlook)
- Typing: 45 WPM
- Strong attention to detail and accuracy