Customer Service Services

DIANA RIVERA

210-***-**** **********@*****.***

Resourceful individuals consistently meet and exceed company goals and are able to resolve issues quickly and effectively. Constantly maintaining a high level of professionalism, patience, and communication.

CORE QUALIFICATIONS

Customer Service Abilities Easily Adaptable to Policies and Procedures Troubleshooting skills Bilingual English / Spanish Able to work under Pressure Problem Solver Computer Skills / 45 wpm Confident and able to Learn Quickly Positive Attitude WORK HISTORY

UnitedHealth Group San Antonio, Texas 8/29/21- Current Hearing Aid Dept Customer Services (REMOTE)

Healthplex Inc merged with UHC grp as of 8/29/21 I continue working as customer service senior rep for this company now in the Hearing aid dept. I continue to perform the function as before…..

● Customers via inbound/outbound telephone calls.

● Verified Hearing aid insurance verification

● Emailed to members provider listing, Referral Letters.

● Demonstrated excellent verbal and written communication skills.

● Update files,confirm insurance eligibility, benefit availability, breakdown of benefits,

● Go over claims Status

● follow up on claims information and predetermination status Healthplex Inc, San Antonio, Texas 05/17/21- 8/29/21 Dental Customer Services Specialist (REMOTE) was hired permanently from Hawkins Personnel Group and continued to perform the same duties.

● Customers via inbound/outbound telephone calls.

● Verified dental insurance verification

● Emailed to members provider listing, Referral Letters.

● Went over appeals denial/approved decisions to members,,submitted member complaints

● Demonstrated excellent verbal and written communication skills.

● Update files,confirm insurance eligibility, benefit availability, breakdown of benefits,

● Go over claims and appeal status

● follow up on claims information and predetermination status Hawkins Personnel Group San Antonio, Texas 8/20/20-5/17/21 Dental Customer Services Specialist (REMOTE)

● Customers via inbound/outbound telephone calls.

● Verified dental insurance verification

● Emailed to members provider listing, Referral Letters.

● Went over appeals decisions,submitted member complaints

● Demonstrated excellent verbal and written communication skills.

● Update files,confirm insurance eligibility, benefit availability, breakdown of benefits,

● Go over claims and appeal status

● follow up on claims information and predetermination status Carenet Health San Antonio, Texas 07/2019 – 08/2020 Engagement Specialist

● Kindheartedly and efficiently out-reached customers via outbound telephone calls.

● Demonstrated excellent verbal and written communication skills.

● Utilized excellent customer service skills.

● Accurately imputed data and maintained patient databases.

● Verified patient insurance information with kindness and accuracy.

● Performed trouble-shooting and coordinating with team Members to resolve customer issues.

● Responsible for understanding and analyzing health plan benefits.

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EDUCATION

Louis E. Dieruff High School High School Diploma Allentown, Pennsylvania

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