Customer Service Administrative Assistant

CINDY CRUZ PEREZ

**** ** ***** ****** ***** Lakes, Florida, 33016 786-***-**** *********@*****.***

Areas of Expertise

Data Analysis ● Data Management ● Client Relations ● Reporting ● Daily Operations Oversight

Project Management ● Training and Development ● Compliance Analyst

Interpersonal Effectiveness: Understands oneself, effectively manages emotions, listens and communicates with respect, and builds trusting relationships

Strategic-relationship/partnership-building skills -- listen attentively, solve problems creatively, and use tact and diplomacy to find common ground and achieve win-win outcomes

Professional History

Beverly Crawford State farm Agency ( April 2015- Current)

Responsible for selling insurance policies and other services, including mutual funds, annuities, and securities, and financial planning services

Explain Benefits and assist in coverages.

Help individuals, businesses, and families select the most appropriate policies for health, life, and properties.

Offer property and casualty, life, health, disability, and long-term care insurance.

Sell policies that protect individuals and businesses from financial loss resulting from automobile accidents, fire, theft, storms, and other events that can damage property.

Offer health insurance policies that cover the costs of medical care and loss of income due to illness or injury.

Advise clients on how to minimize risk.

Advise clients on retirement planning, estate planning, and also provide assistance in setting up pension plans for businesses.

Seek out leads and new clients. Maintain regular contact with clients build relationships, maintain policy

Answer questions and make changes to existing policies

Humana Insurance Representative, Contract Position Miramar, FL (August 2014-July 2015)

Onsite Account Personnel /Service Market Support August 2014 - June 2015

Consulting members the features of health, dental, vision and wellness insurance benefits

Maintain an active role in resolving billing and claim issues

Verify in network providers and coverage

Excellent ability to handle high stress and time sensitive issues

Use best-known practices and develop positive relationships

Ensure and maintain data quality and reliability

Assist in providing information and data sets required for audits by the different state agencies

Ensure that appropriate metrics are developed and goals are met with Humana Vitality

Establish plan implementation guidelines with account management team

Conduct employee group meetings explaining benefits to be offered

Meet with employees (at the employer’s workplace) on an individual basis to educate them on benefits

Work with Sales and Client Executives to ensure correct and timely completion of all enrollment materials

A reputation for professionalism and exemplary ethics. Remain current on the latest trends in the industry, with comprehensive knowledge of financial and insurance products, services and best practices

Jackie Martinez-Sancho Director, Client Management 305-***-**** 1-800-***-****

HEWLETT PACKARD/SAFEGUARD SERVICES, MIRAMAR, FL (Sep 2013 –June 2014)

Complaints Analyst Medicare Fraud Contracted Position September 2013 - June 2014

Manage assigned complaints (WMM) to resolution or into incorporation of existing investigations

Perform necessary research using various Internet resources, MAC screens and Business Object Reports

Escalated complaints or suspect fraud calls from members and providers

Analyze complaints received from Office of Inspector General for Task Order 1 and perform necessary research

Experience in collecting data, evaluating effectiveness, researching and developing new processes

Maintain compliance with Center of Medicare Services, First Coast Service Options and Cigna

Employment Verification: 1-800-***-**** HP Employer Code: 10102

CSI NURSE REGISTRY, Miami Lakes, FL (April 2011-August 2013)

Credentials Coordinator April 2011 - August 2013 Salary

Assist in maintaining Florida Nurses and Home Health aides in compliance

Documentation Orientation and Training for Hospital and Hospice accounts

Responsible for recruiting, training and development of new hires on claims processes and procedures

Developed and maintained outstanding client relationship

Monitor staffers and independent contractors with proper placement

Continuous monitoring of beneficiary insurance coverage

Verify independent contracts thorough screening process in order to understand skills, experience, needs, and desires

Administer, maintain and implement procedures and policies to manage the risk of non-compliance and to deter and detect fraud.

Maintain compliance and ethics policies and procedures

Investigate employment practices or alleged violations of laws to document and correct discriminatory factors.

Study equal opportunity complaints to clarify issues.

Meet with persons involved in equal opportunity complaints in order to verify case information, and to arbitrate and settle disputes.

Coordinate, monitor, or revise complaint procedures to ensure timely processing and review of complaints.

Prepare reports of selection, survey, or other statistics and recommendations for corrective action.

Review independent contracts to determine actions required to meet governmental equal opportunity provisions.

Verify that all job descriptions are submitted for review and approval meeting regulatory standards.

Employment Verification: Maria Llanes 305-***-**** ex.1083

CATHOLIC HOSPICE, MIAMI LAKES, FL (August 2008-April 2011)

Patient Care Secretary / Administrative Assistant August 2008 - April 2011

Created and updated CNA’s schedules to meet patient needs

Maximized reimbursement by ensuring accurate ICD-9-CM and CPT coding and conducting regular quality audits of providers' selected codes compared to chart documentation

Work collaboratively with patient account department to ensure accurate billing and resolve claim denials and medical-necessity issues

Ensure and maintain data quality and reliability

Track and order requested DME services

Maintained team up to date on compliance via critical management reports

Completed voluntary compassion service training to learn ways to enhance patient satisfaction and improve productivity.

Assisted in helping company pass JACHO and AHCA inspections by consistently meeting state requirements

Employment Verification: Laura Del Torro 305-***-**** HR Department

XACT TELESOLUTIONS SERVICES Virtual Care, HIALEAH, FL (March 2006-April 2008)

Customer Service Enrollment Advisor, Administrative Assistant Contract position

Assisted in guiding students with admission procedures and online enrollment

Provide students with information on financial aid programs and explain different options

Knowledge of admission criteria adapted by different educational institutes

Manage and counsel students issues and concerns

Customer Service with strong research based on needs

Identified skills, interests and career goals of prospective students

Certificates of Completion;

Cyber Security- Personally Identifiable Information

Cyber Security- Social Engineering

ES Federal Employee Labor Recording Training 2013

HP Anti-Corruption Training and Certification 2014

HIPAA

Medicare Integrity Program

PL 2-15 - Life, Health and Variable Annuity License

Florida 2-20 Property & Casualty License

Ongoing review of CMS Provider Compliance website

Professional-Related Skills

HTML, CPT Codes

Meta Vance (MTV) Meta Vance Administration and Finance System – Meta Vance 2.1, delivering Web-enabled health care transactions and the latest in Health Insurance Portability and Accountability Act (HIPAA) to health care organizations.

Contract Information System (CIS)

CIS PRO Advance Security Solutions (electronic data exchange file format)

Clinical Guidance Exchange (CGX)

Customer Care Portal (CCP)

Mentor Real time online Code system

Microsoft Office, Adobe Suite, Business Objects, Lexis Nexuis, Sun Biz, Citrix

Languages: Fluent in Spanish (oral and written)

Administrative duties

Customer Service Relations

Executes for Results: Effectively leverages resources to create exceptional outcomes, embraces change, and constructively resolves barriers and constraints.

Customer Focus: Connects meaningfully with customers to build emotional engagement and customer advocacy. Simplifies complexity and integrates internal efforts to deliver an optimal customer experience.

Collaborates: Engages others by gathering multiple views and being open to diverse perspectives,

Ability to write and communicate effectively within multiple communication channels, including telephone and chat environments

The ability to work on a flexible schedule

Contact this candidate