Customer Service Inbound Calls

Jamesy Bazan

Buckeye, AZ *****

***********@*****.***

Cell: 480-***-****

Transparent Health 08/2021-Present

Tempe, AZ

Bilingual Benefits Navigator Representative

●Responsible for taking inbound calls from members and providers in a fast paced environment.

●Assist members with provider nomination submission

●Outbound Welcome Calls educating members of their health plan.

●Provide WOW customer service to ensure that calls are handled in a timely manner without having the member having to call multiple times.

●Provide eligibility and benefit information to both members and providers.

●Use of microsoft excel to enter request of information for claims.

●Send out EOB/EOP by fax and email to members and providers per request.

●Responding to provider emails regarding claim status/payment information.

Celerion 09/2014- 05/2021

Tempe, AZ

Bilingual Study Participant Representative

●Answer inbound calls from the public interested in information regarding clinical study participation.

●Outbound calling to participate from the database, call-out reminder to study participants registered for screenings.

●Screen individuals to match the requirements for participation in studies and offer the study that is starting soon with higher priority.

●Inform and educate participants of specific requirements and responsibilities for individual studies.

●Collect and enter participant information into a computer database to create or update profiles.

●In charge of training all new hires for the call center department as of July 2019.

●QC (Quality control) for all registrations completed using microsoft excel to enter the data as of May 2020.

General Dynamics 05/2008-07/2013

Phoenix, AZ 85021

Bilingual Medicare Benefit Specialist II

●Handled inbound calls in a fast paced environment.

●Handled claims: origination, verification, research, approval, and appeals.

●Claims Specialist Skills Training Certificate.

●Medical Benefit Specialist II Trained.

●Specialized in ICD/9 and CPT coding.

●Disenrollment from drug plans and also filed complaints to drug plans.

●Request copy of checks and reissuing checks.

●Consistently achieve record-high customer satisfaction rankings.

Education and Training:

Medicare: Completed numerous training in customer service, medical claim, hospital claims, part A1&B2 Medicare claims and MBS II.

Celerion: Experienced trainer for all new hires and quality control verification for all registrations completed using excel.

High School Diploma:

Maryvale High School Graduated May 2005

Phoenix AZ 85033

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