Highly organized and experienced professional with 8+ years of experience seeking a challenging position in a field that fully utilizes my organizational abilities, interpersonal/communication skills, and expertise. Excited to contribute to the growth and advancement opportunities offered by this role. Possess extensive knowledge of service delivery and proven multitasking abilities as a dedicated Customer Service professional. Committed to maintaining professional relationships to increase profitability and drive business results.
Overview
26
26
years of professional experience
Work History
Customer Service Representative
United Healthcare Insurance Company
10.2022 - 08.2025
Answering incoming calls to assist members understand their benefits with their Medicare advantage plan, help with member’s benefits, assist with processing premium payments, scheduling provider appointments, searching for and assigning providers, educating members on medical claims.
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.
Fielded telephone inquiries on authorization details from plan members and medical staff.
Authorized surgical requests in accordance with applicable plan guidelines.
Evaluated clinical criteria for approval or denial of services requiring pre-authorization.
Responded to inquiries from healthcare providers regarding prior authorization requests.
Reviewed, analyzed, and managed coding of diagnostic and treatment procedures contained in outpatient medical records.
Assisted with insurance verifications to ensure proper coverage for necessary treatments and reduce financial stress on patients.
Collected, verified, recorded and processed client demographics, insurance payments, and referral information.
Resolved issues through active listening and open-ended questioning, escalating major problems to manager.
Provided exceptional customer service to patients, families, and healthcare providers during the intake process, promoting a welcoming atmosphere.
Attendance Clerk Specialist
Harmony School of Science
08.2012 - 10.2022
Using Skyward for attendance, managing lunch payments, keeping logs for lunch records, data entry for student information, handling incoming calls, and sorting mail.
Aided school administration during emergency drills or actual events by providing accurate attendance information of students and ensuring their safety.
Collaborated with guidance counselors to identify students at risk due to poor attendance and develop appropriate interventions.
Maintained accurate records of all absences, truancy issues, and disciplinary actions.
Pleasantly greeted all office visitors and asked open-ended questions to determine needs.
Enhanced record accuracy by diligently tracking student attendance and updating data in the system.
Demonstrated strong attention to detail when verifying and inputting student data, resulting in a reliable reporting system for school administrators.
Streamlined communication with parents by promptly addressing concerns regarding their child''s attendance.
Input daily attendance information into office database for 350-student school.
Called parents and guardians to inquire about late or truant students.
Assisted in maintaining a positive school environment by participating in disciplinary actions related to attendance issues.
Managed high volumes of incoming calls from parents or guardians reporting absences, ensuring proper documentation for each case.
Improved document organization system which resulted in easier access for staff members when searching relevant files quickly during time-sensitive situations.
Provided excellent customer service by addressing inquiries promptly and professionally via phone or email correspondence.
Managed inventory tracking for office supplies by conducting regular audits of stock levels and placing orders proactively before depletion occurred unexpectedly, avoiding potential downtime due to lack of materials availability on hand.
Maintained a professional appearance at all times while managing reception duties such as greeting visitors warmly, directing them appropriately, and offering refreshments when necessary.
Temp Staff
Texas Sleep Medicine
05.2011 - 09.2011
Verifying insurances, checking in/out patients, managing electronic medical records, collecting co-pays, scheduling appointments, and organizing charts.
Contributed positively to workplace morale by maintaining a professional and positive attitude in all temporary assignments.
Temp Staff
Oakwood Surgery Center
06.2010 - 03.2011
In charge of medical records, billing, calling patients for balances, insurance verification, translating for patients, and front desk duties.
Served as a reliable team player who consistently met or exceeded expectations in all tasks assigned throughout numerous temp jobs.
Learned semi-skilled and advanced work by shadowing experienced workers.
Cultivated positive relationships with coworkers, fostering collaboration and teamwork in diverse work environments.
Supported company growth by quickly adapting to new roles and industries, showcasing versatility as a Temp Worker.
Temp Staff
Sante Pediatrics
01.2010 - 06.2010
Maintaining schedules for therapists, greeting/checking in patients, ordering supplies, translating for parents, and performing clerical functions.
Contributed positively to workplace morale by maintaining a professional and positive attitude in all temporary assignments.
Served as a reliable team player who consistently met or exceeded expectations in all tasks assigned throughout numerous temp jobs.
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.
Office Staff
McDonald Plastic Surgery Clinic
08.2007 - 11.2009
Maintaining schedules, answering calls, data entry, greeting patients, organizing medical charts, and assisting with insurance confirmations.
Administrative Assistant/ Office Manager
Nanny’s ETC
10.2004 - 07.2007
Supervising and training employees, preparing correspondences, maintaining calendars, creating client databases, and performing clerical functions.
Customer Service/Receptionist
Nachos Tires
01.2000 - 10.2004
Answering phones, managing mail, handling visitors, responding to inquiries, drafting correspondence, and assisting accounting with invoicing.
Updated client records regularly, ensuring accurate contact information was readily available for future communications or followups.
Contributed to company growth by actively promoting products and services based on individual customer needs.
Facilitated smooth office operations with timely ordering of supplies and inventory management.
Resolved complex situations calmly, demonstrating professionalism under pressure while maintaining customer focus.
Education
Graduate Certificate - Medical Billing And Coding
Penn Foster College
Scottsdale, AZ
01.2025
Billing and Coding -
Ashworth Univ., Not Provided
01.2008
ROP- secretarial study -
Alhambra, CA
01.2001
H.S. Education -
Alhambra, CA
01.1999
Skills
Self-starter with strong planning skills
Well organized, capable of effectively tasking assignments with logic, determining realistic goals and setting effective priorities
Consistently meet deadlines and objectives; work well under pressure
ELITE INBOUND CUSTOMER SERVICE ADVOCATE at United Healthcare Insurance CompanyELITE INBOUND CUSTOMER SERVICE ADVOCATE at United Healthcare Insurance Company
ELITE INBOUND CUSTOMER SERVICE ADVOCATE at United Healthcare Insurance CompanyELITE INBOUND CUSTOMER SERVICE ADVOCATE at United Healthcare Insurance Company