Traci Burgos
Daytona Shores
Summary
Dynamic Healthcare Customer Service Representative with extensive experience at UnitedHealth Group, adept at HIPAA compliance and insurance verification. Proven ability to enhance patient satisfaction through effective problem-solving and exceptional communication skills. Committed to maintaining accurate medical records and delivering one-call resolutions in high-volume environments.
Overview
10
10
years of professional experience
Work History
Healthcare Customer Service Representative
UnitedHealth Group
Daytona Beach
01.2025 - Current
- Delivered exceptional customer service by addressing inquiries, resolving complaints, and providing clients with accurate information about healthcare services.
- Maintained compliance with HIPAA regulations while handling sensitive patient information.
- Assisted in checking patients' insurance eligibility prior to their appointment.
- Scheduled appointments for patients using the electronic health records system.
- Collaborated with team members to enhance service delivery and elevate customer satisfaction scores.
- Updated patient files in accordance with company policy and procedure guidelines.
- Verified patient demographic information in order to ensure accuracy of data entry.
- Kept patient appointments on schedule by notifying providers of patients' arrival and reviewing service delivery compared to schedule.
- Reviewed eligibility responses to assess patient benefit level and prepare estimates.
MED TECH
Cypress Village
Jacksonville
01.2023 - 01.2025
- Prepared detailed reports documenting test results for physician review and clinical decision-making.
- Received supply of ordered medications and apportioned, mixed or assembled drugs for administration to patient.
- Recognized and reported abnormalities or changes in patient health status to nursing supervisor.
- Managed patient records accurately and efficiently according to HIPAA standards.
- Ensured clean work environment by adhering to safety protocols and procedures.
- Maintained organization and cleanliness of patient rooms, ensuring all supplies and linens were available for staff use.
- Assisted admitting personnel to obtain and record information related to patient's vital statistics and circumstances of emergency.
HEALTHCARE CALL CENTER SPECIALIST
Convergys
Watertown
01.2016 - 01.2019
- Ensured compliance with all regulatory requirements for healthcare services provided by the organization.
- Resolved customer complaints and issues by applying problem-solving techniques, ensuring a swift and effective response.
- Managed escalated calls by actively listening to customer needs and providing tailored solutions.
- Documented patient interactions accurately, capturing details on billing, insurance, medical procedures, and related topics to support service continuity.
- Researched complex insurance claims issues in order to provide accurate solutions in a timely fashion.
- Referred unresolved customer grievances to designated departments for further investigation.
Customer Support
AT&T
- Managed high volumes of incoming calls to ensure customer inquiries were addressed promptly.
- Provided single-contact resolutions to customer issues, streamlining the support process.
- Maintained patient accounts by accurately obtaining, recording, and updating personal and financial information to enhance service delivery.
- Ensured availability of treatment information through efficient filing and retrieval of customer records.
- Cultivated a patient-centered healthcare environment that fostered a welcoming atmosphere for all individuals.
- Is a skilled communicator, kind, detail oriented, and conscientious.
- Is familiar with the mission, vision, and values of the practice expresses a genuine enthusiasm for its success.
Education
High School Diploma -
BISHOP BLANCHET
SEATTLE, WACNA/LPN -
BOCES TECH
Watertown, NYSkills
- HIPAA Compliance
- Electronic health records
- Medical record documentation
- Insurance verification
- Patient eligibility verification
- Claims processing knowledge
- Data entry accuracy
- Vital signs monitoring
- Medical terminology
- Customer relationship management
- Problem-solving techniques
- Effective communication
Hobbies and Interests
- Theater
- Environmental conservation
- Art
- Hiking
- Skiing
- Travel
Timeline
Healthcare Customer Service Representative
UnitedHealth Group
01.2025 - Current
MED TECH
Cypress Village
01.2023 - 01.2025
HEALTHCARE CALL CENTER SPECIALIST
Convergys
01.2016 - 01.2019
Customer Support
AT&T
High School Diploma -
BISHOP BLANCHET
CNA/LPN -
BOCES TECH