Summary
Overview
Work History
Education
Skills
Timeline
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VANESSA GONZALEZ

Montbello,CA

Summary

Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals. Diligent Claims Representative with solid background in processing and managing claims efficiently. Adept at assessing coverage and liability, and resolving complex claims issues.Possesses versatile skills in project management, problem-solving, and collaboration. Brings fresh perspective and strong commitment to quality and success. Recognized for adaptability and proactive approach in delivering effective solutions.

Overview

14
14
years of professional experience

Work History

Customer Service Representative Sr.

Optum
04.2016 - Current
  • Set performance expectations for the team, monitoring progress towards goals and providing constructive feedback as needed.
  • Empowered team members by delegating responsibilities according to individual strengths and areas of expertise.
  • Developed team members'' skills through targeted coaching sessions, resulting in improved individual performance.
  • Coordinated resources effectively to meet project deadlines and achieve desired results.
  • Facilitated decision-making processes within group through open dialogue and clarity .
  • Established clear communication channels to facilitate timely exchange of information between team members and higher ups.
  • Developed and executed training programs that significantly improved team skills and morale.
  • Educated on organizational mission and goals to help employees achieve success.
  • Improved customer satisfaction by providing timely and accurate information on claim status and resolution.
  • Enhanced team productivity by implementing efficient task delegation and regular performance evaluations.
  • Worked productively in fast-moving work environment to process large volumes of claims.
  • Collaborated with internal departments and external vendors to resolve claims.
  • Investigated and resolved complex claims, ensuring adherence to policy guidelines and regulatory compliance.
  • Reduced claim resolution times with thorough documentation and timely follow-up.
  • Determined appropriateness of payers to protect organization and minimize risk.

Supervisor

Fulcrum Inc
02.2011 - 10.2015
  • Oversaw daily operations of the department, ensuring smooth workflow and timely completion of tasks.
  • Increased team productivity by implementing efficient workflows and setting clear expectations for staff members.
  • Identified and resolved unauthorized, unsafe, or ineffective practices.
  • Oversaw inventory management, maintaining optimal stock levels while minimizing waste and excess costs.
  • Supervised operations staff and kept employees compliant with company policies and procedures.
  • Managed inventory and supply chain operations to achieve timely and accurate delivery of goods and services.
  • Led hiring, onboarding and training of new hires to fulfill business requirements.
  • Developed and maintained relationships with external vendors and suppliers.
  • Analyzed and reported on key performance metrics to senior management.
  • Organized spaces, materials and catering support for internal and client-focused meetings.
  • Improved office operations by automating client correspondence, record tracking and data communications.

Education

Cerritos Community College
Norwalk, CA
11-2023

Diploma -

Lynwood High School
Lynwood, CA
08.2010

Skills

  • Time Management
  • Team Collaboration
  • Coverage assessments
  • Coverage Determination
  • Microsoft Office/Excel
  • Insurance Claims Review
  • Claims Investigation
  • Policy Knowledge
  • Allocating claims
  • Documentation research
  • Insurance regulations
  • Claims trend analysis
  • Claims Processing
  • Adaptability

Timeline

Customer Service Representative Sr.

Optum
04.2016 - Current

Supervisor

Fulcrum Inc
02.2011 - 10.2015

Diploma -

Lynwood High School

Cerritos Community College

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VANESSA GONZALEZ