Victor Jara
The Bronx,NY
Summary
Dynamic Customer Support Specialist with extensive experience at excelling in claims processing and health plan navigation. Proven ability to resolve complex issues while maintaining professionalism and delivering exceptional service. Skilled in appointment scheduling and conflict resolution, ensuring optimal outcomes for members and enhancing overall customer satisfaction.
Overview
15
15
years of professional experience
Work History
Customer Support Specialist
Devoted
Waltham, MA
09.2022 - 12.2024
- Received calls from our members to ask about their health plan and to ask about their benefits.
- Searched for doctors and specialists close to the member's residence.
- Transfer calls to different departments to help members with other benefits they have, whether related to mental health.
- Made outbound calls to members to set up appointments with our advanced clinicians and help the members with computer connections for video calls.
- Called the doctor and specialist's office to set up appointments for the member.
Customer Service Advocate
UnitedHealth Group
Kingston, NY
01.2021 - 07.2022
- Received incoming calls from policy members regarding their medical plans and their coverages.
- Advised on medical claims if they needed to be adjusted, and helped members submit the correct documents.
- Helped the customer with questions on their medical billings, as well as on behavioral health, FSA, COBRA, Medicaid, and whether they needed prior authorization for medical procedures.
- I made phone calls to the doctor’s office to have the correct CPT codes sent in order to process claims properly.
- Helped the member by answering their pharmacy prescription questions on their purpose and prices.
- I gave the members the best options for their doctors, specialists, hospitals, pharmacies, medical equipment, and helped them navigate through the United Health Group website.
Collection Specialist
Enhanced Recovery Company
Orange Park, FL
02.2010 - 12.2020
- Received incoming and outgoing telephone calls, and provided professional customer service by assisting with questions about their delinquent accounts.
- Negotiated for a payment or payments for a better outcome, and documented collection communications with the customer.
- Provided customers with proper documents, such as fraud packages and paid account letters.
- Secured payments for assigned delinquent accounts by notifying customers of their debt.
Education
High School Diploma -
Florida Community College
Jacksonville, FL05-1993
Skills
- Customer service
- Health plan navigation
- Appointment scheduling
- Documentation accuracy
- Problem solving
- Communication skills
- Time management
- Conflict resolution
- Team collaboration
- Quality assurance
- Multitasking and organization
- Problem-solving
- Claims processing
- Professionalism
Languages
Spanish
Full Professional
Timeline
Customer Support Specialist
Devoted
09.2022 - 12.2024
Customer Service Advocate
UnitedHealth Group
01.2021 - 07.2022
Collection Specialist
Enhanced Recovery Company
02.2010 - 12.2020
High School Diploma -
Florida Community College
Similar Profiles
Ian ShaoIan Shao
Cook at DevotedCook at Devoted
Kenna HargroveKenna Hargrove
Member Outreach Specialist at DevotedMember Outreach Specialist at Devoted
Maria RodriguezMaria Rodriguez
Transitions of Care Guide at DevotedTransitions of Care Guide at Devoted