Customer Service Representative in Healthcare and Banking

Diligent, results oriented professional with initiative and high emotional quotient skills. Combines a solid track record in challenging business environments across two industries, Healthcare and Banking (processes health claims, highly effective customer service agent in banking and healthcare, processes dental claims, managed macro clinic scheduling, billing and collections, with proven supervisory skills in all specialties).

Career Milestone Achievements

Successfully launched a provider scheduler and customer service call center for Mission City Community Medical Network, on time and under budget.

In Banking, managed a team generating a record $10 million in collections; a watermark for the period achieved.

As a project lead, successfully supported the launch of a bilingual customer service unit serving a customer base of 25,000 clients at Aetna US Healthcare.

Successfully developed high performing cohesive teams, by practicing strong communication and interpretational skills, to ensure cooperative conflict resolution while building strong work relationships through the process.

Exceeded quality and productivity goals at the supervisory level, as well as, at the individual employee level when working frontline roles.

Experience

Bilingual (English and Spanish), technically proficient in Microsoft Office Suite, Windows operating system, Excel, Word, Internet, typing and 10-key. Working knowledge of ICD9/ICD10, CPT, Medical terminology, and government regulations. Expert leveled in serving PPO, HMO, and IPA insurance models. Easily achieved highest quality work outcomes while remaining productive at processing medical claims, and resolving escalated inbound client calls in healthcare and in banking. Federal Debt Collection Practice Act (FDCPA) certified.

Management & Supervision

Employee Retention

Policy & Procedures

Process Implementation

Training & Development

Best Practices

Problem Solving

Value Metrics

Efficient Fast Paced Worker

Regulatory Compliance

Firm-wide expert

High Emotional Quotient

Career Accomplishments

Mission City Community Center, 09/2017 – 4/2020 (Business impacted by Cov19)

Scheduling / Call Center Supervisor

Managed 20 associates

Scheduled medical, dental, and behavioral health appointments for 24 clinics

Set up and launched scheduling and call center department

Team consistently exceeded company key performance indicators

Followed and administered policy and procedures

Managed new hire recruitment and new hire training

Reported performance results to executive management

Successfully worked on organizational special projects

AltaOne Federal Credit Union, 10/2015- 2/2017

Call Center Manager

Managed a team of 15 associates

Independently managed daily team operations

Responsible for new hire recruitment, hiring, and new hire training

Managed multiple investor segments

Managed departmental collections, and routinely exceeded collections goal: > $2M a year

Managed collections and OSHA reporting for the site

Managed Call Center Core and Digital Conversion

Bank of America, 8/2007-6/2015

Home Loan Bilingual Collections Team Manager (Spanish)

Managed a team of 17 associates

Supported Department Mortgage repayment plans for FHA and Conventional loans

Set and approved up Escrow accounts

Processed cancelations of foreclosures with Fannie Mae and Freddie Mac loans

Updated home insurance and PMI accounts

Assisted in the process of approving loan modifications

Independently managed daily team operations

Side by side monitoring segments with individual associates to improve service levels.

Radnet Radiology, 08/2005 - 7/2007

Call Center Customer Service Manager

Managed ### of associates in fast paced inbound call center

HR compliance

Implemented new Scheduling system

Reported monthly production to upper management

Conducted new hire training classes

Collect TECH, 01/2002 – 07/2005

Call Center Collections Manager

Managed associates in fast paced inbound call center

Reporting monthly Production

Project agent on the implementation of new collections and phone systems.

Trained new hires

Reported Monthly Pay Roll

Team building motivational events / trainings

FDCPA Certified

Aetna US Health Care, 03/1994 – 12/2001

Customer Service Unit Team Leader

Managed a bilingual team of 25 representatives (English and Spanish)

Managed specialty geo-based team – processed claims

and handled customer calls

Trained and implemented new company policies and guidelines

Worked collaboratively with Human Resources and fully

managed employee administrative needs

Exceeded performance standards: 15 calls an hour, 98% phone adherence

99% Financial accuracy and 96% statistical accuracy processing claims

Education

Training/Certification Provided by Aetna Us Healthcare

Leadership Identification Development Program certification

How to get your employees to perform

How to be an effective leader

Franklin Time management

How to handle conflict

How to handle Changes

Effective Communication

Conflict Resolution

10 key, ICD 9, Current Procedure Terminology (CPT), and Claim processing

Pierce Community College, Woodland Hills, CA - 1990-1991

Business Management

El Camino Real High School, West Hills, CA - 1986-1990

General Studies

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