Customer Service Manager
Resume:
Miriam Villanueva
Cell: 917-***-**** Email: **********.********@*****.***
SUMMARY OF QUALIFICATIONS
More than twenty years of extensive experience in administrative/executive support within the medical/hospital settings. During my professional career I obtained experience in working with Chairman, top level physicians and managers. To my advantage I am proficient with Microsoft Word, Excel, PowerPoint, Group Wise/Out-Look, EZ-Time Kronos System, EMEDNY System, eChamp and am Bilingual in Spanish.
WORK EXPERIENCE
CENTERLIGHT HEALTHCARE SERVICES, Brooklyn, New York
Authorization Specialist: Sept. 2015 – Nov. 2015
Work closely with Site Manager and Nurse Case Manager with reviewing clinical data matching it against medical diagnosis or procedure codes for further review.
Accurately entering required information into eChamp computer data base.
Maintained patient confidentiality as defined by HIPPA, State, Federal and Company regulations.
Updating all clinical diagnosis and medication given by Social Workers, Case Managers, Licensed Registered Nurses or Home Health Aides, into database for each member as required via interim orders.
Exceptional interpersonal, organizational skills covering 5 sites, example: Rockaway Pkwy, Bushwick, Allerton, Chrystie Street and Wallenstein.
Responsible for providing accurate and complete data input for pre-certification requests and excellent customer service.
Problem solving, detail oriented, strong analytical skills.
Ability to multi-task and meet deadlines.
Distributing incoming/outgoing mail.
Postage Stamp machine for correspondence.
MAXIMUS Corporation Inc., New York, New York
Enrollment Broker/Customer Service: Dec 2014 – Aug 2015
Respond to phone inquiries in a courteous, prompt and concise manner.
Provide assistance to consumers using unbiased information to help with eligibility requirements.
All data functions accurately performed in order to reflect consumer’s activity and transactions.
Assist in giving a very clear interpretation of all documents or letters consumer’s receives which needs more explanation.
Answer all consumer’s calls on a timely fashion as needed.
Data entry
Assist with all problem solving solutions
Assist all consumers with the enrollment or transferring of appropriate selected Health Plans.
Provide all necessary documentation in a clear and detailed database log on a daily basis.
Provide consumers with needed information regarding Managed Long Term Care.
NYC-Built It Back, Ft. Tilden, Breezy Point Queens, New York
Case Manager/Family Case Worker: April 2013 – Oct. 2014
Knowledge of community resources and counseling/social work practices with high risk populations.
Provide holistic and comprehensive case management services to all clients/applicants.
Full Corporate trainer for a total of 10 to 15 onboard managers, employees, providing them with the proper material, skills and knowledge to efficiently manage their prospective roles as needed within the managerial department.
Maintain a case load of 45 applicants on a daily basis.
Follow up on all accounts payables/receivable through Solix assigned to me, making sure all receipts and invoices are created to applicants as needed.
Work closely with Legal department ensuring confidentiality of documentation as needed.
Input accurate and complete data for all contacts with clients into agency database.
Ensure that all documents submitted on behalf of a client/applicants are valid.
Ability to work independently with strong sense of focus, task-oriented, non-judgmental, open personal qualities, clear sense of boundaries.
A strong sense of and respect of confidentiality involving both clients and fellow co-workers.
Ability to motivate others toward achieving goals.
Excellent written and verbal communication skills, ability to establish rapport.
Metropolitan Hospital Center, New York, New York
Chief Executive Assistant – Jan. 2012 - Dec. 2012
Provided coverage for the Administration Office when needed.
Followed up with 311 Cases, Patient related issued, Departmental Overtime and Pay Roll.
Scheduled meetings as requested and follow up in attendance.
Reviewed any mail requesting signature.
Prepared Expense Reimbursement Form and follow up with Home Office (Bellevue) for expediting payment.
In the absence of the Chief Deputy Director, executed and resolved any problem that arise.
Prepared correspondence for the Deputy’s review and signature.
Montefiore Hospital and Medical Center, Bronx, New York
Administrative Assistant Sept. 2004 - Dec. 2011
Assisted the Administrators and Assistants within the Department of Nuclear Medicine
Prepared the payroll on the Kronos System for the entire department on a daily basis
Processed all billing, check requests, accountant receivable/payable, purchase requisitions and followed up with payments as required.
Assisted physicians with documents for their Journal Club presentation and coverage of front desk area with making copies of documents and charts for patient files.
Scheduled appointments to and from the medical park as needed; included preparation of abstract booklets for SNM meetings in varies locations; at times served as a Patient Advocate
Prepared all employees reimbursement forms for associates and visiting doctors
EDUCATION
American Intercontinental University 2/09 - 01/11
Business Management in Healthcare Hoffman Estates, IL
Diploma / Associates Degree Awarded
Katharine Gibbs School 07/92-08/94
Administrative / Executive Secretarial Studies New York, NY
Diploma Awarded
Borough of Manhattan Community College, 09/90 – 6/92
Business Management in Real Estate New York, NY
Diploma Awarded
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