Venesa L. Gonzales
Denver,CO
Summary
Customer-focused and driven professional with over 20 years of experience in the healthcare industry. Highly skilled in effective communication, client services, membership enrollment, and health-related services. Proven ability to work independently and as a team leader. Adept at identifying and resolving issues on the spot to ensure smooth workflow. Excellent time management and organizational skills, consistently meeting deadlines. Thrives under pressure and consistently delivers accurate results.
Overview
33
33
years of professional experience
Work History
Account Executive
Kaiser Permanente
01.2017
- Responsible for retention, increased membership and sale of new products and services for existing accounts
- Achieve membership, revenue and margin targets for assigned book of business
- Create and execute business plans to ensure attainment of group specific goals
- Develop and execute demonstrations and presentations to employer groups
- Ensure execution of effective sales strategies
- Develop strategic partnerships to optimize account growth.
Engagement Specialist II
Kaiser Permanente
- Current
- Accountable for creating sales opportunities through targeted enrollment activities to increase membership and build support for the organization
- Establish and maintain customer relationships to optimize potential for growth
- Identify, create and execute on an engagement plan
- Establish and maintain internal communication links to ensure timely and accurate onboarding of prospective members
- Identify customer needs and develop appropriate solutions.
Client Account Specialist
ConSova Corporation
01.2013 - 01.2017
- Responsible for performing weekly client project updates and reporting
- Facilitates client meetings, call monitoring, coaching call center associates on proper protocol and the handling of calls for assigned projects
- Consult and strategize with clients to ensure growth and success of projects
- Ensure call center representatives are aware of the full client project scope
- Also responsible for all implementation tasks outlined by the client as well as making sure that they are implemented in a timely and accurate manner while maintaining the client relationship
- Responsible for maintaining excellent professional relationship with the clients
- Handles multiple national accounts and responsible for ensuring all clients work is done appropriately on time.
AR Specialist
Orion Western Skies Billing
01.2012 - 01.2013
- Responsible for setting up patient accounts and ensuring the accuracy of demographic and insurance information
- Billed patient insurance for services rendered by contracted providers
- Handled billing inquiries from patients on direct bills received from providers
- Also responsible for account receivables on outstanding balances, & charge postings.
Stylist
Regis Corporation
01.1992 - 01.2013
- Provides quality service, maintains health and safe conditions by following legal regulations
- Active listening to clients needs
- Provide attention to detail, creativity and good verbal communication
- Ability to analyze client needs and features to produce desired results
- Provide all services related to hair cutting, styling, coloring and texture
- Obtain revenue by obtaining and collecting charges
- Additional skills, organization, confidentiality, professionalism and customer focus.
Senior Customer Quality Specialist
Apria Healthcare
01.2008 - 01.2012
- Managed individual customer accounts which included the reconciliation of orders and confirmation of insurance coverage for Medicare eligible customers
- Created subcontract orders and established services for patients through other providers in other states and areas not covered by the company.
Suspended Billing Representative
Apria Healthcare
01.2007 - 01.2008
- Worked with customers to obtain authorizations and prescriptions needed to bill the health insurance companies for suspended revenue
- Worked with various referrals, doctors and our sales team to obtain missing documentation.
Customer Service Specialist
Great West Healthcare
01.2005 - 01.2007
- Responsible for answering customer telephone calls regarding questions or concerns about their insurance
- Consistently improved customer satisfaction through expert resolution of conflicts, issues, and concerns.
Provider Contracting Specialist
HMS Colorado
01.2005 - 01.2005
- Coordinated directly with healthcare providers for the purpose of re-credentialing HMS physicians
- Assisted providers with contractual issues and updates for contract renewals.
Third Party Bill Review Specialist
Concentra Integrated Services
01.2002 - 01.2003
- Reviewed health claims associated with auto injuries
- Responsible for billing reconciliation for both adjusters and attorneys in relation to auto claims
- Research and create Demand Package Reviews and provide findings to insurance carriers.
Membership Account Manager
Pacificare
01.1998 - 01.2002
- Responsible for membership and account reconciliation for employer groups ensuring payment accuracy, summarizing and posting data and or cash receipts to ledgers and other records
- Responsible for maintaining excellent professional relationship with the clients
- Develop and execute account business plans to ensure growth and retention of assigned block of business
- Track client progress and report analysis to executive team.
Customer Service Analyst
Pacificare
01.1996 - 01.1998
- Assisted both members and providers with complex benefit and claim inquires which included analyzing and responding to payment, policy and procedural inquiries
- Also investigated member complaints in regards to claims and customer service issues via written correspondence.
Education
Veterinary Tech Certificate - Veterinarian Assisting
Bel-Rea Institute of Animal Technology
2010
Certification- Cosmetology -
Xenon International School of Hair Design
01.1992
Diploma-General Studies -
Denver West High School
01.1991
Skills
- Client Relationship Building
- Account Management
- Relationship building and management
- Pipeline Management
- Written and verbal communication
- Customer Service
- Customer Relations
Timeline
Account Executive
Kaiser Permanente
01.2017
Client Account Specialist
ConSova Corporation
01.2013 - 01.2017
AR Specialist
Orion Western Skies Billing
01.2012 - 01.2013
Senior Customer Quality Specialist
Apria Healthcare
01.2008 - 01.2012
Suspended Billing Representative
Apria Healthcare
01.2007 - 01.2008
Customer Service Specialist
Great West Healthcare
01.2005 - 01.2007
Provider Contracting Specialist
HMS Colorado
01.2005 - 01.2005
Third Party Bill Review Specialist
Concentra Integrated Services
01.2002 - 01.2003
Membership Account Manager
Pacificare
01.1998 - 01.2002
Customer Service Analyst
Pacificare
01.1996 - 01.1998
Stylist
Regis Corporation
01.1992 - 01.2013
Engagement Specialist II
Kaiser Permanente
- Current
Veterinary Tech Certificate - Veterinarian Assisting
Bel-Rea Institute of Animal Technology
Certification- Cosmetology -
Xenon International School of Hair Design
Diploma-General Studies -
Denver West High School
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