Customer Service Enrollment Specialist

Liz Rodriguez

*** ********* *****, *** *******, Texas, 78228• 210-***-**** •**************@*****.***

SUMMARY To find a job fulfilling a customer service or entry-level position where I can continue to grow

professionally. I have over fifteen years of customer service experience and am ready to start a

career in a new environment that’s healthy and positively inspiring.

EDUCATION High School Diploma, Thomas Jefferson High School

San Antonio College- 9 hours from Associates Degree- In Progress

COMPUTER SKILLS Windows Office, Word, Excel, Facets, Collect Logix, Meditech, AS400, Streamline, Onbase, and

10 key by touch, type 60 wpm

EXPERIENCE

June 2019 to Bistro LTD and Staffing

Current Catering and Server

Work events throughout the city for RK Group one of the top catering business’ is the

State of Texas. Work as server and set-up for GALAS and BALLS with the upper class

community and city representatives.

January 2018 to Wells Fargo Home Mortgage

November 2018 Account Resolutions Specialist

Communicate with home owners with delinquent accounts, as well as in foreclosure.

Assisted home owners in determining what type of program they qualified for in their

particular situation.

April 2013 to Conn's Call Center

October 2017 Collections

Started collections at Conn's on 04/02/2013 and have collected on the 15-30 bucket and

collecting currently 151+ bucket.

● Have been successful in my collections at Conn's taking incoming calls and collecting above

the 20 percentile thru the months I have been there.

October 2012 to Coventry

February 2013 Customer Service

Temporary assignment to handle calls for Medicare Open Enrollment, took incoming calls

daily, back to back and helped members fill out applications and quote them benefits of their

selected plan and prescription costs on their years plan.

● Assignment was from Oct 2012 - Feb 2013

January 2012 to Medtronic

September 2012 Account Specialist II

● Use multiple programs to conclude collections from payers for Diabetic Supplies.

● Use GE for viewing the accounts for hundreds of payers our current AR is 45 million from

600 million of AR in Jan 2012.

● The team is given an amount of payers in which we work on daily. I call for claim status on

low and high dollar denied claims and what is necessary to get the claim paid.

● Fax document request to Dr's office for LMN's and Medical Records and follow-up with the

payers to overturn the claims for payment.

● If necessary we have different scenarios in the system to work on collections, such as charge

correction to get the correct insurance fsc to load the correct contract for expected

reimbursement.

● Follow-up on large payer issues by forwarding to supervisor.

MARY RODRIGUEZ Page of 2

January 2010 to Christus Santa Rosa Health Systems

January 2012 Collector, Validator, and Team Lead Assembly Department

Originally was hired to collect on Medicare Advantage Plans, worked with many and all

Medicare Replacement Iplans. After a few months was created, the Assembly department in

which all collector's forward a checklist of necessary information to be gathered such as

medical records, eob's, ub's and any all type of appeal letters to go out for payment. I was the

Team Lead for this department for 8 months and took back my collections position as it was

an upgrade, so currently working as collector and validator for Managed Medicaid and

Medicare Replacements.

July 2009 to XL Health

January 2010 Provider Relations Research Representative

Utilize systems such as Facets, Streamline, Onbase, Facets, EAM, and Streamlite, And Marx

in order to pull up case issues forwarded to us for resolution of Provider issues. These issues

could pertain to contract issues, claims being denied in error, work large spreadsheet in

reference to old claims back as far as 2007. Work with Enrollment Specialist to help out with

the open enrollment period at this time.

March 2006 to HCA Patient Account Services

September 2008 Overpayment's Analyst

Verify medical insurance and patient payments made on accounts against insurance contracts

to determine overpayment is valid. Document all action taken per audit guidelines, and

document contract dates and contracts used to determine. Issued refunds to insurance or

patient if necessary, could range from low dollar to high dollar. Work on month end deadlines.

January 2002 to United Healthcare Group

September 2004 Customer Service Representative

Answer inbound calls daily, quoting dental benefits and claims status. All information quoted

based on the individual group contracts; adjudicate claims based on the discrepancies

reported. Work well with high call volume.

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