Contact Representative Verification Specialist

Natalie Alvarez-Browne

Dublin, CA ***** • ***************@*****.*** • 980-***-****

Bilingual Customer Service and Benefits Coordinator

Profile

Skillful and well-trained bilingual Benefit Verification Specialist with demonstrated ability to handle inbound and outbound calls in a timely manner with attention to detail.

— Key Qualifications —

Proven track record of accurately verifying commercial and Medicare Insurance eligibility utilizing specialized programs.

Adept at learning new job-related systems or resources: Patient Plus, Enterprise document cabinet, and RightFax.

Highly focused and results-oriented in supporting complex, deadline-driven operations; identify goals and priorities and resolve issues in initial stages.

Customer focused; ability to prioritize and efficiently manage multiple assignments.

Proficient in Office 365, Windows 11 type 60 wpm.

Knowledge in HCPCS, CPT, ICD-9, AND ICD-10 coding, billing, pre-authorizations, and reimbursement

Referral request and approval and Mentee to New Hires

Professional Experience

HUMANA HEALTH-CHARLOTTE, N.C, 2021-2022

Inbound Contact Representative 2

Addressed member needs which may include complex benefit questions, resolving issues, educating members, and delivering best-in-class member experiences.

Handle 40-50 inbound calls daily from members in a fast-paced inbound call center environment, and at times, back-to-back phone calls. Documents accurate details of inquiries, comments or complaints, transactions or interactions and records all actions taken in accordance with the request or questions being asked. Escalated unresolved and pending member grievances and appeals. Decisions are typically focused on detailed processes and area/department policies and methods for completing assignments. Worked within defined parameters to identify work expectations and quality standards, but has some latitude over prioritization/timing, and works under minimal direction. Followed standard policies/practices that allow for some opportunity for interpretation/deviation and/or independent discretion. Participates in daily team chats, accesses a knowledge-based database (Mentor) on every call, and reads emails daily to stay on top of alerts, trainings, and all Medicaid updates/changes.

ACO USA – Fort Mill, 2020-2021

Export Sales Representative and Customer service coordinator 2020-2021

Handled all the export calls inbound and outbound created quotes and placed orders and sent invoicing to customers to receive payment and updated all the files in the systems. Tracked all containers that were for export and keep the customer up to date.

AmerisourceBergen - Fort Mill, SC

Benefit Verification Specialist-2016-2019

Verify and process benefit information ensuring accuracy, data integrity, and maintaining a high-level of confidentiality. Confirm outgoing faxes sent to site and providers. Assist with co-pay referrals and serve as a resource for team members with questions or experiencing issues. Support and comply with all company policies, processes, and procedures including Compliance Program and the Code of Conduct. Core Team associate. 3 years part of AR exceed goals and helped in reverification, patient list, fax reviewer, co-pay approvals and other special projects assigned. Was a mentee for new hired employees.

Selected Contributions:

NATIONAL SOCIETY OF LEDERSHIP AND SUCCESS (NSLS)

HONOR SOCIETY

LATIN HIGH HONORS

HIGH HONORS IN BUSINESS

Additional Experience

Medical coding and billing

Director of Recruiting

Customer Service rep

Administration assistant

Receptionist/Front Desk

Office assistant

Sales in person and over the phone

CNA - UNC-Healthcare

Medical Records

Bilingual in Spanish

Educational Background

Southern New Hampshire University

AS in Business Administration

Southern New Hampshire University

BS in Business Administration

in HR Management

References upon request

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