Yraiza Bolling
Brooksville,FL
Summary
Detail-oriented professional with extensive experience in prior authorization and billing resolution. Skilled in problem-solving and regulatory compliance, ensuring accurate customer account management and timely resolutions.
Overview
10
10
years of professional experience
Work History
Customer Service Advocate
Centene
Brooksville, Florida
06.2024 - Current
- Communicated with healthcare providers regarding missing or unclear information.
- Reviewed prior authorization requests for accuracy and completeness.
- Documented all interactions in the electronic health record system.
- Coordinated with other departments to obtain additional information needed for prior authorization.
- Provided guidance to providers regarding the prior authorization process.
- Provided customer service to patients and healthcare providers, answering questions related to prior authorization and insurance coverage.
Billing Resolution Specialist
Centene
Tampa , FL
10.2019 - 06.2024
- Processed billing inquiries and resolved discrepancies in customer accounts.
- Communicated with customers to explain billing procedures and clarify charges.
- Utilized payment processing systems to manage account transactions efficiently.
- Reviewed and processed customer billing inquiries and disputes to facilitate timely resolutions.
- Investigated discrepancies between customer records and internal systems, identifying root causes of billing errors to prevent recurrence.
- Ensured compliance with company billing resolution policies, maintaining integrity and accuracy in customer accounts.
- Received payments and posted amounts to customer accounts.
Customer Service Representative I
WellCare
Tampa , Florida
10.2016 - 10.2019
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Assisted customers with inquiries and resolved issues promptly.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Managed multiple customer accounts while maintaining attention to detail.
- Utilized CRM software to track customer interactions and preferences.
- Mentored junior team members and managed employee relationships.
Education
High School Diploma -
Tampa Bay Technical Vocational H.S.
Tampa, FL06-1986
Skills
- Prior authorization
- Claims resolution
- Electronic health records
- Call center support
- Customer relationship management
- Account management
- Data entry
- Microsoft Office Suite
- Problem-solving
- Verbal and written communication
- Policy adherence
Languages
Spanish
Professional
Timeline
Customer Service Advocate
Centene
06.2024 - Current
Billing Resolution Specialist
Centene
10.2019 - 06.2024
Customer Service Representative I
WellCare
10.2016 - 10.2019
High School Diploma -
Tampa Bay Technical Vocational H.S.