Customer Service Sales

[pic] Qualification Profile [pic]

Motivated and astute professional offering broad knowledge in management,

sales, customer services, administrative support, and marketing;

demonstrated more than five years of experience in health managed

organization environment and background in administrative support, project

management, health delivery support, provider relations, and government

assisted programs. Multilingual in English, Spanish, and Portuguese.

[pic] Core competencies [pic]

Marketing Knowledge of principles and methods in showing, promoting, and

selling products or services that includes marketing strategy

and tactics, product demonstration, sales techniques, and sales

control systems.

Customer Service Knowledge of principles and processes in providing customer and

personal services, which includes assessing customer needs,

meeting quality standards for services, and evaluating customer

satisfaction.

Health Delivery Certified Nursing Assistant, Medical Biller/Coder, EKG

Technician and Phlebotomist. Experience in servicing patients

with various diagnoses.

[pic] Work History [pic]

Plan Coordination Consultant 2008-2010

Aetna, Inc. ( High Point, NC

. Plan set-up and consultant for 8 Fortune 500 Companies

. Responsible for Implementation calls, customer meetings and issue

resolution through a consultative approach

. Collaboration with Marketing, Legal Departments and Third Party

Administrators to ensure customer satisfaction

. Extensive knowledge of health insurance products, laws and legislative

policies that are used daily

. Very high volume environment that requires multi-tasking, strict

attention to deadlines and 100% quality in product development

National Accounts Administrative Assistant 2007-2008

Aetna, Inc. ( New York, NY

. Support four Vice Presidents of Sales, Account Manager, and Medical

Director of Sales/ Marketing

. Administer project management and marketing support for Marketing Manager

. Prepare expense/ budget reports, calendar management, travel

arrangements, including meeting and event planning

. Present administration development of visual presentations such as

PowerPoint presentations, charts, posters, and binders, spiral bound

booklets for medical, dental, plan sponsor products, disability, stop

loss, and disease management products to support sales professionals

. Assume office wide functions of Corporate Races, Blood Drives, Flu Shot

events, and Fundraisers

Accomplishments:

Designed and developed the ERM (Enterprise Relationship Management) Model,

which supported Sales Vice President in tracking customer interaction

development

Provider Relations Associate 2006-2007

HIP Health Plans of New York ( New York, NY

. Supported Direct and IPA provider networks in issues that required

coordination with various plan departments

. Established and retained ongoing professional relationships with

participating providers

. Determined and resolved issues concerning access to care, transportation,

claims, authorizations, and status of new providers

. Trained new and seasoned network providers on policies and procedures to

ensure program compliance

Large/ Small Business Department 2005-2005

Administrative Assistant

. Assisted staff of eight accountants and four senior management personnel

. Prepared letters, pamphlets, memos, and notifications for approximately

more than 20,000 customers

. Updated management manuals, directives, organizational charts inside the

department

. Handled numerous reconciliation projects to identify discrepancies

between client rosters and internal billing system

. Assisted clients through phone to gather information regarding billing

status of accounts to include payment info, reinstatements, and enrollment

of new members

Accomplishments:

Successfully developed the Access Database system that facilitated MS Word

Generated Documents mailing and maintenance

Eligibility Specialist, Government Assisted 2002-2005

Programs

. Monitored contractual benefits such as Medicaid, Medicare, Child Health

Plus, Family Health Plus, and Direct Pay policies

. Accomplished several projects, which corrected system discrepancies

. Checked reports created by LDSS (Local Department of Social Services)

. Provided solution to customer and provider issues in a high volume

environment

Senior Secretary 1999-2002

Eye4U Informatica ( Sao Paulo, SP-Brazil

. Supported staff of seven computer technicians; performed general office

work, data entry, and scheduled conferences meetings

. Developed Access Database for stock control and performed various duties

as assigned

[pic] Education [pic]

Bachelors of Arts, Major in English/Education

Universidade de Sao Paulo, Sao Paulo, SP - Brazil: 2002

Associates Degree; Major in Early childhood Education

Ashworth College, Norfolk, GA: 2009 (In progress, expected graduation in

2010)

[pic] Certifications [pic]

Medical Coding & Billing, Certified Medical Coder, Manhattan Institute, New

York, NY: 2007

Certified Nursing Assistant Training, Partners in Care, New York, NY: 2010

EKG & Phlebotomy, Certified EKG and Phlebotomist, Manhattan Institute, New

York, NY: 2010

NY State Public Notary Course, NY State Public Notary License# 01FE6179200,

NY Real Estate Institute, New York, NY: 2007

Bookeeping, Zanchi & Fairbanks Escola de Negocios, Sao Paulo, Brazil: 2002

[pic] Professional Training [pic]

Training Courses at HIP:

< Health Insurance Law & Ethics -2003

< HIPAA Regulations -2004

< Customer Service Excellence -2006

< Rumba Q/Care Training -2003

Training Courses at Aetna:

< Concur -2007

< HIPAA -2007

[pic] Activities [pic]

< Member/ Volunteer, New York Blood Centers

Contact this candidate