Luis Castillo

Healthcare Specialist

Orlando, FL 32826

ad4qsu@r.postjobfree.com

+1-407-***-****

• Clinical Crisis intervention training for mental health using CASIC methodology.

• Experienced Medicare & Medicaid Specialist.

• Expertise in Medicaid, Medicare, A.C.A., Small group benefit programs.

• Outstanding And extended experience as a customer service representative within medical & pharmaceutical insurance benefits; for both English and Spanish customers. Fluent medical terminogy knowledgeable.

• Knowledgeable and experienced clinical psychometric assessment analyst: I.Q., personality, primary cognitive abilities, emotional IQ, social abilities.

• Knowledgeable and trained to execute first hand crisis interventions over the the phone.

• Expertise with clinical diagnose for all DSM-IV and CIE-10 psychological disorders.

• Passionate Psychologist professional, with high moral values and professional ethics; strong bilingual-interpreter experience.

• Self-driven and self-motivated and detail oriented.

• Proven capability to take over diverse Psychology areas: Educational, Social, Organizational and Clinical; based upon Psychological assessment for both American and Latin community workforce. Authorized to work in the US for any employer

Work Experience

TTEC Patient Care Advocate

TTEC - Orlando, FL

March 2018 to Present

• Claims Advisor II - Blueshield California Insurance

• Worked hand by hand with United healthcare Community & State Insurance and Department of Children and families for the state of Florida, DHS. Also providers offices, clinics and hospitals

• Assigned multiple states to deliver customer care services for each state funded Medicaid program, such as New York, Arizona, Michigan DHS, North Carolina. Explain and educate members on benefits through the state funded program and go above and beyond while providing customer care service

• Scheduled medication mail order delivery

• Process test claims to determine drug coverage and estimated copayment.

• Processed test claims to determine drug coverage according to health plan’s benefits Patient Care Coordinator

Health care Scouts - Orlando, FL

March 2017 to August 2017

Patient Care Coordinator I.

• Determined eligibility information with insurance companies and enhanced benefits.

• Reached out to providers to ensure prescription dosage and strength.

• Initiated prior authorization processes.

• Determined prior authorization status with physicians.

• Provided medical & pharmaceutical benefits description for medicaid beneficiaries several states.

• Processed over the counter medication orders for Home Scripts.

• Execute remarkable advisory service for current members on specific both prescribed and OTC benefits according to the State's plan benefits.

• Educate customers on both prescribed and non-prescribed drugs benefits for their current insurance plan Sunshine Health Plan & Superior Health Plan.

• Processed reshipment orders.

• Processed orders for foster children "Child Wellfare" accounts. Enrollment Specialist

Dial America/Contact Center - Orlando, FL

September 2015 to February 2017

September/2015-February/2017

Level I Healthcare enrollment specialist.

Firsthand Medicare Advantage plan Enrollment Level I

• Entered and processed information for prospects for Healthfirst medical insurance which provides health coverage services

• Determine eligibility for senior population/Medicare qualified New York resident applicants, on Medicare part C options.

• Verified the information with Medicare data base for eligibility and prospects.

• Work in conjunction with Medicaid programs, Leaf programs, children insurance and provide exceptional customer service while recommending other options.

• Set up and scheduled home appointments for field representative to approach potential customers.

• Scheduled seminar appointments for interested customers for the Mount Sinai network

Geisinger Health ACA Tax Credit Counselor.

• Provide tax credit eligibility on applicable plans.

• Deliver exceptional customer service attention for inquiries on benefits on medical insurance.

• Provide assistance on searching for primary care physician and specialist information.

• Provide updated information on benefits for current 2017 spam.

• Updated data base for 2017 on customer's files.

Education

Bachelor's in Psychology

Catholic University of Honduras - San Pedro Sula

May 2007 to December 2013

Skills

• Psychometric Evaluation. (2 years)

• Recruiting (2 years)

• Patient Care

• Microsoft Word

• Microsoft Office

• Spanish

• English

• Outpatient Therapy (1 year)

• Multilingual

• Hospital Experience

• Medical Scheduling (5 years)

• Medical Records

• Insurance Verification (5 years)

• Medical Terminology (5 years)

• Mental Health Counseling

• Translation

• Crisis Intervention

• Individual / Group Counseling

• Interpretation

• Team Work

• Problem-solving

• Reliability

• Customer service

• Bilingual

• Customer support

• Communication skills

• Insurance verification

• Translation

• Recruiting

• Medical terminology

• Phone etiquette

• Data entry

• Organizational skills

• Spanish

Certifications and Licenses

Driver's License

September 2019 to Present

Assessments

Project timeline management — Proficient

June 2020

Prioritizing and allocating time to effectively achieve project deliverables Full results: Proficient

Indeed Assessments provides skills tests that are not indicative of a license or certification, or continued development in any professional field.

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