Customer Service Manager

Professional Summary

Skills

Experience

ANDREA ULIBARRI

**** ****** *****

Denver, CO 80249

Ph: 720-***-****

************@*****.***

Accomplished and energetic Health Outreach Specialist, and Nursing Unit Secretary with a solid history of achievement in patient, and member services. Motivated leader with strong organizational and prioritization abilities. Areas of expertise include high level of customer service, excellent communication and time management. Neatness, organization, very

analytical, detail oriented, ability to

work in diverse groups, strong

problem solving, proficient in windows

1997-2002, advance training in word,

excel, outlook, access, powerpoint,

and lotus notes, Meditech. EPIC,

ACSR, BES/GUI, BLISS, Martin

Legacy, CPI willing system, DLS,

WANG, ProComm plus, Run (telnet),

Citrix ICA client, Netscape navigator

(java), ICOMS, LNIE, Illuminet,

MediaVantage, Telemagic, Macola,

City Lookup, Samson Production,

Remedy, Lucent CentreVu, Ecura,

Cavion, WMDS, CITRIX, WMGS #2,

STAR and Internet. Attended special

training in Sexual Harassment,

Humans Resources Management,

Diversity, and Personality. Advanced

training with Microsoft products such

word, excel, powerpoint, and project

manager., critical thinking, complex

problem solving, quality control

analysis, social perceptiveness.

Nov 2015 -Dec 2017

Westminster, CO

Nursing Unit Secretary

Centura Health

Administrative duties supporting up to 20 employees, which includes Nurses, and Doctors. Register, admitting, and discharging Patients. Also, assisting with Patient care. Special projects as assigned, such as auditing for quality assurance. Create maintain, and enter information into databases. Set up and manage paper or electronic filing systems, recording information, updating paperwork, or maintaining documents such as consent forms, correspondence, or other material. Compliant with HIPPA regulations, and protect PHI for patients. Operate office equipment, such as fax machines, copiers, or phone system, and arrange for repairs when equipment malfunctions. Greet visitors and handle their inquiries, or direct them to the appropriate persons, or unit according to their needs. Use computers for various applications, such as database management or word processing. Operate electronic mail systems and coordinate the flow of information, internally or with other organizations. Train new, or current employees to enhance associate performance.

Jan 2004 -Sep 2014

Denver, CO

Health Outreach Specialist III

Anthem Blue Cross Blue Shield

Extensive customer service. Administrative, and clerical duties for clinical managers. With up to 50 care managers as assigned using Microsoft applications such as excel, word, powerpoint, and project manager. Upheld sensitive, and confidential information in compliance with HIPPA Laws, PHI-Protected Health Information, and departmental policies. Utilization management, and case management for Behavioral Health and Medical services. Provided "Social Work" services to Members, which included extensive research to provide resources upon request from members. Researched correspondence from Providers requesting visits for outpatient treatment, ensuring all required clinical data is indicated for review. Verified eligibility for members, and reviewed outpatient treatment report forms from providers requesting authorization for more visits with our members. This included review of medical information provided for authorization. Obtained clinical data from facilities requesting authorization for intensive services for Inpatient, Partial, and Intensive Outpatient services for Care Managers to review for authorization. Created reports, and provided analysis of outcomes for data assigned to me from management. Generate denial letters due to medical necessity or benefit design to facilities, and providers for all levels of care. Assist in providing resources to members after discharge for intensive services. Assisted with new software implementation, which included testing for several months. Extensive claims research, for fraud and abuse, and up-coding. Assisted in auditing for quality assurance. Provided classroom, and web based training to current and new employees. Also created, and updated job aides by utilizing Microsoft office powerpoint, and PDF. Trained new, and current employees to enhance associate performance.

Nov 1999 -Jun 2003

Englewood, CO

Assistant Production Agent

AT&T Broadband

Extensive internal and external customer service. Provision, and build a telephony line from SWITCH. Build features such as voicemail, disconnect, soft disconnect, and activate the telephony line. CARE billing, and build E911 thru the counties, townships, and cities nationwide. Extensive E911 research, PORT/Non PORT, LNP/SMS, LNIE, and repair thru the NOC. Provision caller ID, call waiting, 3 way calling, and feature packages. Administrative duties for Management, and lead supervisor. Special projects as assigned, and training to enhance associate performance

Education

Nov 1996 -Oct 1999

Denver, CO

Assistant Supervisor

Mellon Mortgage Company

Extensive customer service. Conducted staff evaluations, monitored activities to predict upcoming issues. Utilized Lucent CentreVu supervisor software program to monitor up to 50 customer service representatives. Conducted auditing for quality assurance, and followed up with the customer service representative to review the level of service they are providing to the customer. Made outbound calls to collect on past due accounts. Accounts payable, and receivable using coding. Assisted Executive Liaison Department for high priority customers with return calls for CEO of company. Researched 90% all incoming correspondence for high priority customers. Create projects, and daily reports for upper management. Conducted training for new, and current employees to enhance associate performance. Answered calls with a Que. That is able to hold 100 incoming calls.

Denver, CO

May 1994

High School Diploma

North High School

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