Customer Service Call Center
Resume:
Ingrid Cadenas
Apt #***
Pomona, Ca 91767
ad203b@r.postjobfree.com
PROFESSIONAL SUMMARY
Bilingual: Fluent in Spanish
Medical Terminology
Logistics, Customer Service
Excellent written and verbal communication skills
Respond quickly to resolve customer service issues
Proficient in E-Clinical Works, SAP, and All-Scripts software
Experienced with Electronic Medical Records
Ability to learn and adapt to new technology platforms
Assist in facilitating, analyzing and resolving customer issues
Verify insurance, authorizations, eligibility and benefits
Proficient in multi-line phones, switchboard operator
Strong clerical and administrative support
Experienced in a high-volume medical call center, managed 80-100 inbound/outbound calls from patients, insurance representatives, and physicians.
Ability to manage multiple tasks within a fast-paced environment.
Provide superior service that assists callers in all aspects of the interaction including assisting callers on the first point of contact, demonstrate a high level of patience and respect, and avoid distractions to ensure each caller is assisted promptly and appropriately in a timely and effective manner.
Proficient in building trusting relationships with customers and being attentive to their needs.
Customer focused, resolve customer issues and able to quickly identify clients request or concerns.
Switchboard/PBX experience.
Proficient in MS Word, MS Outlook, MS Office Suite, Excel, MS Office, Scanners, Sorters, Facsimile, 10-key, and Copiers.
Typing proficiency of 60 wpm.
Review medical reports and issue authorizations and denials based on medical and financial eligibility.
Strong critical thinking skills in making sound decisions and resolving issues in a clear and calm manner.
Responsible for ensuring successful care and case management processes to ensure positive member outcomes using critical thinking and innovative techniques.
Proficient on maintaining medical records, following policies and procedures relating to HIPAA laws, and ensuring the privacy and security of protected health information.
Highly effective communication skills with health care members, insurance providers, and physicians.
Ability to handle a multitude of assignments, meeting all given deadlines.
Strong attention to detail and organization.
Practice a high level of integrity, respect, compassion, punctuality, teamwork, enthusiasm, and accountability.
Strong work ethics built on a foundation of pro-activity and teamwork.
Strong desire and passion to help and serve others
EXPERIENCE
American Standard Water Heaters 10/22-01/23
Logistics-Customer Service Specialist
Bilingual
Processed customer orders
Entered Sales Orders information into SAP System
Answered phone calls on a multi-line phone system, and providing solutions related to customer service, sales and warranty information.
Verified product warranty inquiries, and issued Return Merchandise Authorizations.
Maintained a calendar of shipments arrivals and deliveries from El Paso, TX,Laredo Tx, and Mexico to the United States on all Sales Orders and Deliveries
Provided excellent sales support to territory Sales Agents and Regional Sales Managers, in addition to daily interactions with Production and Shipping departments.
Ensured the highest levels of customer satisfaction, through all communication channels – phone, email, online chat, and continued to learn new technologies as they emerged.
Maintained accurate records and data.
Assisted the warehouse with Shipping and Receiving
Processed Credit Returns for damaged merchandise
Extensive Data Entry
Processed invoices for payment
Oversaw all paperwork associated with the orders
Communicated with drivers and customers via email and phone
Pacific Clinics – Behavioral and Mental Health Services 02/22-09/22
Call Center Specialist
Bilingual: Spanish
Front desk medical administration
Interaction with managers, consultants, and other multi-disciplinaries
Heavy phones (80-100 calls/day), emails and correspondence
Assist callers who are in need of immediate services due to a crisis situation and help stabilize the situation
Maintain a log of all calls not tracked by the computer software
Arrange for eligible people to receive initial assessment of various Los Angeles County programs
Model Pacific Clinics’ approach, mission and core values in all communication and correspondence
Assists with follow-up on referrals from ACCESS service and referral number
Complete screening and registration forms and collect and process insurance information
Complete all documentation within the timeliness for service delivery
Report to work on time and maintain reliable and regular attendance
Attend and participate in staff meetings to provide input towards program development
Answered all incoming/outgoing calls in a pleasant and professional manner
Ability to handle a multitude of assignments meeting all given deadlines
Aspen Family Medicine and Geriatrics 06/21-12/21
Medical Phone Operator-Customer Service
Bilingual: Fluent in Spanish
Performed excellent customer service skills with all clientele
Handled a very high volume of inbound calls, 80-100 inbound/outbound calls per day
Scheduled patients using E-Clinical Works Software
Verified patient referrals and insurance benefits and eligibility
Scheduled patients for Tele-Health appointments
Constant phone communication with patients, referring physicians, medical groups, and internal staff.
Schedule, reschedule, confirm, and/or cancel appointments as requested by the patient, and make every attempt to find an appointment that meets the patient needs.
Communicated with physicians regarding prescriptions, health assessments and physicals.
Ability to communicate professionally and effectively on the telephone.
Ability to enter information quickly and accurately in the EMR system while listening to the patient.
Document no shows/cancellations/add-ons.
Have the ability to respond to changing workload and work environment..
Responsible for complying with HIPAA standards and observing strict patient confidentiality.
Risser Orthopedic Group 02/18-04/21
Patient Service Representative-Call Center
Bilingual: Fluent in Spanish
Responsible for high volume of inbound calls/outbound calls, 80-100 per day
Verified eligibility and benefits
Scheduled radiology procedures: Bone Density, Mammograms, Ultrasound, MRI, and CT.
Assist in identifying the reason for calls and respond accordingly in a timely and effective manner.
Obtained doctors’ orders, authorizations, clinical notes, and labs when needed.
Work with health care team in assuring prompt processing of referrals and responded promptly and appropriately to patient requests.
Demonstrate dignity with kindness and compassion to all patients, visitors, and staff.
Scanned all referral requests, authorizations and consult notes into the patient’s electronic medical record.
Assist in completing daily tasks by participating in meetings and working closely with the management.
Complete notifications telephonically by generating letter notifications to inform of authorized medical treatment and determination requests.
Accurately document information received from clients, provider offices, and health plans and entered into the EMR online clinical system.
Strong attention to detail and organization skills.
Schedule, reschedule, confirm, and/or cancel appointments as requested by the patient, and make every attempt to find an appointment that meets the patient needs.
Safely screen patients for contraindications of radiology procedures.
Constant phone communication with patients, referring physicians, medical groups, and internal staff.
Updated and maintained call center database by entering information on every call.
Responsible for complying with HIPAA standards and observing strict patient confidentiality.
Strong work ethics built on a foundation of pro-activity and teamwork.
Pacific Eye Institute 06/17-01/18
Customer Service-Call Center
Bilingual: Fluent in Spanish
Ability to handle large call volume, 80-100 per day, both inbound/outbound
Create and maintain necessary records and files for efficient operation.
Answered inquiries by clarifying desired information, researching, locating, and providing information.
Maintained medical records and followed policies and procedures on HIPPA guidelines.
Work with health care team in assuring prompt processing of referrals and responded promptly and appropriately to patient requests.
Strong professional communication with physicians and patients
Proficient in Microsoft Word and Microsoft Outlook.
Actively participated in departmental staff meetings and training sessions.
Increased member satisfaction by following up and resolving member issues, complaints, and questions in an efficient, timely and accurate fashion.
Provided follow-up with members by clarifying the customer’s issue, determining the cause, and identifying and explaining the solution.
Responds appropriately and in a timely fashion to members and providers by answering telephonic and written inquiries concerning benefits, eligibility, referrals, claims and all other issues following departmental policies and procedures.
Blue Shield Healthcare Services 01/16-05/17
Patient Contact Center Representative II
Bilingual: Fluent in Spanish
Ability to handle large call volume, inbound/outbound, while providing excellent customer service.
Entered pertinent medical information and referral authorization requests into the EMR.
Strong work ethic built on a foundation of pro-activity and teamwork.
Actively participates in departmental staff meetings and training sessions.
Increased member satisfaction by following up and resolving member issues, and complaints.
Ability to handle large call volume, while providing excellent customer service
Experienced with medical terminology and strong medical background.
Effective communication (oral and written) skills and a professional, pleasant telephone manner.
Provides follow-up with members by clarifying the customer’s issues, determining the cause, and identifying and explaining the solution.
Maintained impeccable documentation skills keeping the customer well informed and accurate notes in database system.
Responsible for complying with HIPAA standards and observing strict patient confidentiality.
California Children Services, Department of Public Health 02/01-12/15
Case Management/Client Services
Bilingual: Fluent in Spanish
Maintained an active caseload of 800 patients and served as a liaison between care providers, families, patients, and community resources.
Identified and addressed the needs of patients and their families; functioned as a liaison between patients and providers and communicated with patients and/or family regarding health status.
Collaborated and communicated with all members of the healthcare team.
Provided education and support to our members and caregivers.
Conducted clinical and medication assessments, developed, implemented, evaluated, and developed individualized care plans.
Reviewed and revised medical reports and issued authorizations, denials, and referrals.
Assessed and coordinated resources to assist patients and worked closely with all departments to ensure that programs and services are accomplished in a timely and efficient manner.
Primarily focused on the severity of illness of patients and intensity and appropriateness of medical services required during an inpatient stay and additional functions included planning, implementation, and evaluation of plans of care as well as ongoing concurrent monitoring of appropriateness, and in conjunction with hospital and community resources.
Performed patient review for appropriate care and setting via telephone, followed guidelines and policies, and approved services. Issued authorizations and denials, coordinated, and assisted with follow up patient appointments as needed, and notified.
Responsible for complying with HIPAA standards and observing strict patient confidentiality.
EDUCATION
University of Phoenix 2012-2016
Bachelor’s Degree: Health Sciences, Biology
GPA: 4.0
AFFILIATIONS
California Honor Society
President’s Honor Roll
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