Experience

South Florida Community Care Network, LLC

• Member Coordinator

  • Nov 2014 - Present

  Receive and respond to customer inquiries to ensure timely and accurate resolution to pateint account issues. I'm responsible for communicating with physicians, insurers, patients and dependents via telephone for several lines of business. I act as a liaison between members, physician offices and various HMO's and Medicaid plans. I educate physicians and members about the insurance plan, provide eligibility, benefits, authorizations and claims information. I make PCP changes in the system and resolve member and/or provider billing issues. Show less



Humana

• Brazil
• Professional Training and Coaching

• Customer Service Specialist

  • Apr 2014 - Sep 2014

  Receive and respond to customer inquiries to ensure timely and accurate resolution of patient account issues. Educate physician office and members about insurance plan. Make outbound calls to welcome new members to Humana. Complete health assessments forms and send to disease management. Process and scan HRA forms. Process and mail id cards. QA/Research Team-I monitored inbound/outbound calls and checked assessments created by reps and provided necessary feedback. Receive and respond to customer inquiries to ensure timely and accurate resolution of patient account issues. Educate physician office and members about insurance plan. Make outbound calls to welcome new members to Humana. Complete health assessments forms and send to disease management. Process and scan HRA forms. Process and mail id cards. QA/Research Team-I monitored inbound/outbound calls and checked assessments created by reps and provided necessary feedback.



CVS Caremark Corporation

• Customer Service Rep/Lead

  • 2008 - 2012

  •Process new mail order prescriptions request via phone from physicians and patients •Effectively diffuse and resolve member issues regarding prescription request •Educate patients on the benefits of the mail order prescription process •Research and investigate delays on orders and provide timely feedback to patients and doctors •Explain insurance benefits to patients and physician office •Performed data entry functions to update patient/physician office information in our database •Provided floor coverage and assisted team members with process questions •Conduct new hire and up-skill training for the department Show less



Warren Fence Co, Inc

• United States
• Hospitals and Health Care

• Office Manager

  • Oct 2003 - Oct 2008

  •Managed office daily operations •Conducted weekly meetings •Create employee work schedule and implement adjustments due to customer needs •Investigated and resolved customer issues in regards to their accounts/orders •Responsible for sending and receiving faxes, keep documents in an organized manner •Responsible for payrolls, accounts receivable/payable, bank deposits •Responsible for opening and closing the office •Responsible for other office duties as they were assigned •Managed office daily operations •Conducted weekly meetings •Create employee work schedule and implement adjustments due to customer needs •Investigated and resolved customer issues in regards to their accounts/orders •Responsible for sending and receiving faxes, keep documents in an organized manner •Responsible for payrolls, accounts receivable/payable, bank deposits •Responsible for opening and closing the office •Responsible for other office duties as they were assigned



Timbar Packaging

• United States
• IT Services and IT Consulting
• 1 - 100 Employee

• Customer Service/Accounting Clerk

  • Jan 1999 - Jan 2003

  •Performed daily office functions, customer service & receptionist details •Responsible for accounts receivable/payable •Responsible for daily general ledgers, file invoices daily •Assist customers with orders and quotes/daily data entry functions •Researched account disputes and billing discrepancies/collections •Ability to screen and prioritize a high number of calls •Performed daily office functions, customer service & receptionist details •Responsible for accounts receivable/payable •Responsible for daily general ledgers, file invoices daily •Assist customers with orders and quotes/daily data entry functions •Researched account disputes and billing discrepancies/collections •Ability to screen and prioritize a high number of calls