Customer Service Representative
Resume:
Raymond
Medina
Customer Service Representative
Peoria, AZ
**************@*****.***
20+years of healthcare industry insurance and administrative experience with excellent written and verbal communications.
Supervised team of 20 full time employees, 10 part-time workers and several independent contractors., Proficient computer skills in Microsoft word, office, PowerPoint, Outlook, Excel and other software programs. Highly organized, great attention to detail, excellent time management, learn quickly and meet deadlines with the ability to multi task in fast paced environment.
Professional Experience
Alert Security
Surprise, AZ 85379
Security Marketing Consultant
Jan 2019 - Current
Resolved customer complaints regarding sales and service Determined price schedules and discount rates
Reviewed operational records and reports to project sales and determine profitability Monitored customer preferences to determine focus of sales efforts RemX
Phoenix, AZ 85016
Case Manager for McKesson Pharmaceutical
Company
Oct 2018 - Jan 2019
Responsible for obtaining all prior authorization documents, including the medical records of patients for insurance companies purposes in decision making process for possible approval of specialty medication. Actively involved with patients, medical providers and healthcare insurance companies. Effectively respond to escaladed issues and complex cases to defuse stressful situation with compassion and understanding, try resolve situation in calmly and professional manner. Review case outcomes of patients that have been denied appeal process, analyze, offer solutions and recommendations for alternative programs for funding. Alert Security
Surprise, AZ 85379
Security Marketing Specialist
Sep 2016 - Oct 2018
Quoted prices and persuaded customer to buy using prepared sales talk Developed lists of prospects using telephone directories and other resources Monitored alarm panes and video equipment to enhance safety and security Operated base station, dispatching officers and logging all activity Blue Cross Blue Shield of Arizona
Phoenix, AZ 85021
Claims Examiner
Jan 1997 - Sep 2016
Various positions held during 20+ years of employment with Blue Cross Blue Shield of AZ Medical Review Pre-cert Specialist position: responsible for determining if pre-cert authorization is required. Claims Examiner position: verified accuracy of billing data and revised any errors and processed claims. Underwriting Supervisor position: underwrite for customers applying for individual plans with BCBSAZ. Provider Service Specialist: managed credentialing process for new providers for contracting with Blue Cross Blue Shield of AZ and educate providers on how to use company systems. Pharmacy Service Specialist position: responsible for processing claims and reviewing pharmacy pre-cert authorization for approval of medication drug.
Provider Service Specialist position: managed credentialing process for new providers for contracting with Blue Cross Blue Shield of AZ and educate providers on how to use company systems. Education
Chicanos Por La Casa Jan 1990 - Mar 1990
Phoenix, AZ
Maricopa Skill Center May 1990 - Jun 1991
Phoenix, AZ
Licenses & Certifications
Insurance Broker License
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