Tasha Baldonado
Sugar Land,TX
Summary
Skilled in developing strong customer relationships and loyalty through effective communication.
Highly organized and detail-oriented worker, with a drive to exceed expectations. Ability to analyze data, develop strategies, and provide solutions to complex problems, and seeking to leverage skills and knowledge to contribute to team success.
Overview
9
9
years of professional experience
Work History
Advocate4me
UnitedHealth Group
Houston, TX
06.2025 - Current
- Assisted in maintaining HIPAA compliance with strict adherence to privacy regulations during data entry tasks.
- Educated members on eligibility requirements, coverage options, and benefits
- Advocated on behalf of clients to resolve coverage issues, denials, and billing disputes
- Explained prescriptions drug plans, Medicare and Medicaid, Dual complete
- States current on policy updates and changes in CMS regulations
- Demonstrated strong communication, empathy, and problem solving
- Answered inbound calls regarding benefits assisting members with PCP changes, prior authorizations, claims, appeals, and grievances, DME
- Assist members with case management by getting them in contact with their assigned service coordinator
- Outbound calls to assist members with setting up appointments with providers
Customer Service Representative
ACT-Employees Retirement Systems of Texas
Harlingen, TX
11.2023 - 12.2024
- Maintained detailed records of customer interactions, ensuring proper follow-up and resolution of issues.
- Ensured HIPAA compliance by adhering to strict confidentiality guidelines when handling sensitive patient information.
- Answering inbound calls regarding Benefits and CAC. Assisting members with PCP changes, Medical/Prescription Authorizations, Claims, Appeals and Grievances, DME. Assist members with case management by getting them in contact with their assigned Service Coordinator if needed
Customer Service Representative
Advanced Customer Technologies
Harlingen, TX
02.2020 - 10.2023
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Collaborated with team members to develop best practices for consistent customer service delivery.
Customer Service Representative
Dish Net
Harlingen, TX
02.2017 - 08.2019
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
Education
Texas State Technical College
Waco, TXHS Diploma - Diploma
Harlingen High School
Harlingen, TX05.2011
Skills
Business Information Management Course
Experience with appeals and grievances process
Experience with Medicaid & Commercial healthcare plans
Experience with HCBS patients
Knowledge in Prior Authorization procedures & builds
Knowledge of ICD10 codes & procedure codes
Knowledge of state, federal laws, agency regulations
Experience with MCO’s
Experience with Behavioral health services for members with Intellectual and Developmental Disabilities as well as Severe and Persistent Mental illness
Case management experience
Great rapport with both customers as well as peers and management
Experience with Outlook, Word, Excel and PowerPoint
Ability to multitask
Timeline
Advocate4me
UnitedHealth Group
06.2025 - Current
Customer Service Representative
ACT-Employees Retirement Systems of Texas
11.2023 - 12.2024
Customer Service Representative
Advanced Customer Technologies
02.2020 - 10.2023
Customer Service Representative
Dish Net
02.2017 - 08.2019
Texas State Technical College
HS Diploma - Diploma
Harlingen High School