Robert Gonzalez

ad1mak@r.postjobfree.com

708-***-****

Professional Experience

BlueCross Blue Shield of Arkansas / Hornet Staffing April to Sept 2023

Provider Preauthorization Intake Specialist (Contract)

Handling incoming calls from Providers for the purpose of creating applications for preauthorization requests.

Also cancelled and initiated changes to preauthorizations using Diagnosis and CPT codes per request.

Bright Health Ins., Mo Oct 2021 to Jan 2023

Bilingual (Spanish) Membership and Enrollment Specialist (contract and hired)

Handling incoming calls from members for the purpose of effectuation, cancellation, and reinstatement.

Performing refund requests for active, and ex-members due to overpayments and cancellations.

Performing payment processing as well as well as the set-up and disabling of automatic payments.

Performing ticket/case escalations for member account inconsistencies, as well as coverage and billing issues.

Integrated Resources/LINCARE LLC, Chicago, IL Apr 2021 to Sep 2021

Customer Service Representative (contract)

Handled orders for oxygen tanks, concentrator supplies and scheduled maintenance for all oxygen devices for all oxygen patients.

Set up discharge tanks for patients being discharged from Chicago area hospitals.

Transferred services for patients moving to other states to be serviced by corresponding office.

Insight Global Staffing /Go-Health Inc., Chicago, IL Sep 2020 to Jan 2021

Health Plan Advisor/Licensed agent-producer (contract)

Health Plan Advisor/Licensed agent-producer

Enrolled new members into FFM qualified Network health and dental plans with and without regard to advanced income tax credit and cost sharing, as it applies Bronze/Silver level health plans while adhering to all HIPPA Standards

Achieved the highest level of sales, for the month of December 2020, among 8 team members.

Advanced Resources /HUB International Apr 2018 to Aug 2020

Customer Service Representative

Performed Turborater quotes for over 20 different major insurance carriers.

Performed auto, home, flood and umbrella policy cancelations using Epic software.

Performed endorsements for additional auto(s), driver(s), and coverages according to client’s needs.

Initiated the resolution of all types of billing/Check issues.

Informis (formerly Vangent) Health Solutions Inc., Chicago, IL Aug 2017 to Dec 2017

Bilingual (Spanish) Plan Enrollment Representative

Set up licensed agent appointments with prospective members for the purpose of enrollment into Scan Medicare advantage health plans.

Set up seminar reservations for prospective members for the purpose of enrollment into Scan Medicare advantage health plans.

Fulfill requests for Medicare advantage health plan literature to be mailed to prospective clients.

Manage all inquiries regarding Scan Health Plan benefits, as well as coverage details including copays, and coinsurance.

Achieved the highest number of in-home agent appointments for the months of September and October.

Beacon-Hill Staffing /Access Community Health System, Chicago, IL Feb 2017 to Jul 2017

Bilingual (Spanish) Field Research Data Specialist (contract)

Interviewed and enrolled Diabetic patients into the “Food for health” clinical study for the purpose of improving “food insecure” patient outcomes using Epic medical software for scheduling new participants.

Secured and scanned all HIPPA compliant authorization/consent documents to allow patient participation and researcher access to lab results for the duration of the study (August 2018).

Achieved the highest level of appointments for the first three months out of six.

Go-Health Inc., Chicago, IL Sep 2015 to Jan 2017

Licensed Health Plan Advisor - Agent/Producer

Enrolled new members into FFM qualified BCBS Network health and dental plans with and without regard to advanced income tax credit and cost sharing, as it applies Bronze/Silver level health plans while adhering to all HIPPA Standards

Achieved the highest level of sales, for the month of January 2017, among 18 team members.

Valence Health Inc., Addison Group Staffing, Chicago, IL Mar 2015 to Aug 2015

Member/Provider Services Representative (contract)

Answered 40 to 50 calls from members and providers regarding “Land of Lincoln” Healthcare policies benefits, coverage, and claims, while strictly adhering to HIPPA privacy policy for patient health information.

Preformed provider and member assistance with portal registration, as well as password resets as needed.

Initiated claims reviews when claims were processed “out of network” in error.

Provided preauthorization/precertification approval information on behalf of providers and members.

Initiated check trace requests on behalf of providers in regards to their claims payments.

Go-Health Inc., Lasalle Network Staffing, Chicago, IL Sep 2014 to Feb 2015

Licensed Health Plan Advisor - Agent/Producer

Presented FFM qualified Blue Cross/Blue Shield healthcare, and dental plans to prospective clients seeking to enroll, or change health care plans according to their particular health care needs.

Enrolled new members into FFM qualified BCBS Network health and dental plans with and without regard to advanced income tax credit and cost sharing, as it applies Bronze/Silver level health plans.

American Intercontinental University, Roth Staffing, Schaumburg, IL Jun 2013 to May 2014

Bilingual (Spanish) Admissions Advisor (contract)

Took inquiry calls from all potential students interested in information about Associates and bachelor’s programs, utilizing only approved company materials, and academic standards and encouraged qualified prospects to schedule an appointment for follow up and enrollment.

Interviewed potential students to explain the programs being offered and matched the degree program’s benefits and advantages to the student’s skills and goals. Discussed and advised suitable programs in accordance with the student’s desires, qualifications and objectives.

Maximus Corporation, Apple One Staffing, Chicago, IL Dec 2012 to May 2013

Bilingual (Spanish) Eligibility Customer Specialist (contract)

Determined eligibility for Medicaid medical recipients, according to plan guidelines as determined by health programs.

Requested government issued documents to support identity, citizenship, residence and other aspects of the case from program recipients.

Responded to Medicaid recipient calls in a timely manner and their questions as well as concerns regarding their medical cards and make them aware of the redetermination process.

The College of Office Technology, Chicago, IL Jun 2011 to Jun 2012

Admissions Representative

Performed new student enrollment for Computer and Medical programs using College conditions and guidelines quoting tuition prices, terms, and pre-screening for financial aid eligibility as set forth by The Department of Education guidelines.

Performed heavy outbound phone contact with school and self-generated leads while maintaining a high level of productivity to meet or exceed established admissions goals.

Networked with a variety of contacts including existing students to promote the College and generate personal leads.

Partnered with local High Schools for the purpose of on-site recruitment at their annual career fairs.

Vangent, Northbridge Staffing, Chicago, IL Aug 2010 to Mar 2011

Bilingual (Spanish) Enrollment Representative (contract)

Performed inbound customer service for Elderplan of New York; setting up licensed agent appointments for the purpose of enrolling new Medicare insurance supplement plan members and new plan selections for existing members, according to Medicare guidelines and HIPPA regulations.

Was responsible for the highest number of enrollments into premium plans, while maintaining retention levels.

Set the highest number of licensed agent home appointments for the 2010 open enrollment period.

Education

Morton College, Cicero, IL, 2004

Associate in Liberal Studies Degree (ALS)

Certification

Licenses and associated certifications optained:

Agent/Producer - Healthcare license 2014

Agent/Producer- Life license 2016

Agent /producer- Property and Casualty 2019

Microsoft Office Certification (DMO)

Phi Theta Kappa Honors Society

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