Customer Service/care coordinator

Kathleen D Castro

Case Manager

Summary:

Everyday duties consist of contacting Medicare beneficiaries that are eligible for programs available to them on behalf of their Insurance companies.

Explain the program to help them qualify and assist the member by following up to gather all proper documents the state requires.

Helped clients find physicians, lost ID Cards, Provider directory books, and changes of PCP

Follow the MSP position which entailed prescreening members to participate in the Medicare savings program.

Contact patients that had an outstanding bill with hospitals, explained to them that they may be eligible for Medicaid.

Assisted patients in completing an online application and informed them of the necessary paperwork to complete Medicaid application process.

Answered High Volume Calls (100-180 call per day)

Responsible for Data Entry, Filing, Mailing

Proficient in Microsoft Word, Excel, PowerPoint and SPSS Marketing System

Assisted member in Receiving lower cost on their Prescriptions Also Medicare Part B and got promoted to case manager

Bilingual in Spanish

Education:

Barbara Goleman High – April 2005 – High School Diploma

Miami Dade College – Present – Associates Degree

Skills:

Proficient in Microsoft Word, Excel, PowerPoint and SPSS Marketing System

Proficient in Quick Books operating system

Excellent customer service skills and bilingual

Proficient in generating and closing outside sales, consistently exceeding sales quotas

Excellent management and employee training skills

Experience:

Magellan Complete Care (Medicaid Health Plan) Dec 2015 – Feb 2016

Customer Care Associate:

Answered over 100 inbound calls each day regarding client inquiries and issues

Resolved each customer call within 3-5 minutes

Provided clients with extreme customer service; assisting them with any and all of their needs

Worked primarily with clients that had been diagnosed with a mental or chronic illness

Helped clients find physicians, lost ID Cards, Provider directory books, and changes of PCP

Gap in employment: Jun 2014- Nov 2015

She had a baby

Med Assist Solutions Jan 2014 – May 2014

DCF Representative (Call Center)

Main objective was to contact patients that had an outstanding bill with hospitals, explained to them that they may be eligible for Medicaid. Assisted them in completing an online application and informed them of the necessary paperwork to complete Medicaid application process.

Answered High Volume Calls (100-180 call per day)

Responsible for Data Entry, Filing, Mailing

Dealing with Personal Information such as Bank Statement

Avmed Oct 2013 – Dec 2013

Medicare Sales and Retention

Started off as an Event Planner, my job role consisted of setting up events and registering customers to Avmed insurance. Called third party vendors to set up events.

Event planning and coordinating

Signing up customers to Avmed

Data Entry

Follow up with local customers to remind them of event date

Altegra Health/Social Service Coordinators Dec 2008 – Feb 2013

Case Manager / Outreach Department (Call Center)

Everyday duties consist of contacting Medicare beneficiaries that are eligible for programs available to them on behalf of their Insurance companies.

I explain the program to help them qualify and assist the member by following up to gather all proper documents the state requires.

Answered High Volume Calls (100-180 call per day)

Responsible for Data Entry, Filing, Mailing

Dealing with Personal Information such as Bank Statements

Second Party Companies Such As Social Security, Life Insurance and Health Insurance Companies.

Achievements:

High Quality score

Great mentor to co workers

Consistent conversion rate

Social Service Coordinators Jul 2006 – Dec 2008

MSP Intake / LIS Specialist

LIS Position required assistance to Medicare beneficiaries to help lower cost in prescription drugs. In addition GT position allowed me to enroll members into community based programs.

Then follow the MSP position which entailed prescreening members to participate in the Medicare savings program.

Answered High Call Volume (Inbound 200 per day/Outbound180)

Assisted member in Receiving lower cost on their Prescriptions Also Medicare Part B

Achievements:

Promoted to case manager

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