Customer Service Front Desk
Resume:
Full Name
Phone number or email Page * of *
Patricia Menendez
***************@*****.***
Miami, FL 33174
CUSTOMER SERVICE/ADMINISTRATIVE SPECIALIST
Organized and dedicated professional with more than 15 years in customer service/medical field. Exceptional capacity to multitask, manage competing priorities while fostering delivery of superior customer/client care. Highly focused and results oriented in supporting dead-line driven operations. Outstanding interpersonal and communication skills in English and Spanish. CORE COMPETENCIES
Effective collaborative skills.
Strong oral and written communication skills.
A strong working knowledge of Microsoft Office products.
Strong knowledge of medical terminology
Worked in costumer/client service for the last 20 years
Customer service specialist (English & Spanish) CAREER HIGHLIGHTS
Ability to prioritize work load when processing referrals and authorization requests pre guidelines and within specified Turn Around Timeframes.
Ability to process high volume of requests with a 95% or greater accuracy rate. PROFESSIONAL EXPERIENCE
DR ANGELINE PRADO 10/2009-10/2018
INT MED/PEDIATRICS
As the Front desk Leader I was responsible for effective patient and work flow at the site. The front desk supervisor/authorization employee i worked with the Office Manager and Lead Physician to support the site’s business success, and acts as a bridge of communication between the staff and the physicians. The Front office Supervisor, in collaboration with the Office Manager/Administrator, I was responsible for overall site operations to include but not limited to: human resources, space planning, employee training. My responsibilities included staff including scheduling, monitoring time and attendance, performance management and evaluations while also being responsible for task functions as well overseed staff to ensure procedures and tasks are completed correctly with specific focus on customer service and patient flow. Demonstrated excellent ability to lead and motivate a team and successfully hold them accountable
Proven superb interpersonal skills to effectively communicate and approach customers, employees, physicians and management in a tactful manner.
Proven ability to assess and manage work flow using sound judgment and problem solving skills to identify areas for improvement and implement change.
Established success in maintaining composure when confronted with fast-paced and stressful situations.
Ability to read and write simple to complex correspondence. Full Name
Phone number or email Page 2 of 2
Proficiency with the Microsoft Suite including Word, Excel and Outlook.
EMR experienced and Eclinicals experienced
Authorizations Representative
Preferred Medical Plan 03/2007-04/2008
Experience with FACETS or other healthcare databases. Experience with Health Plan Utilization / Claims departments.
Customer service experience. Prioritizes incoming Prior Authorization requests.
Processes incoming requests, including authorizing specified services, as outlined in departmental policies, procedures, and workflow guidelines.
Refers authorization requests that require clinical judgment to Prior Authorization Clinician, Manager, or Medical Director.
Meets or exceeds position metrics and Turn-Around Timeframes while maintaining a full caseload.
Supports Prior Authorization Clinicians.
Answers ACD line calls, verifies member eligibility and enters into CCMS or Facets the information necessary to complete the caller’s request.
Identifies and informs callers of network providers, services, and available member benefits.
Informs provider of decision per department procedure.
Coordinates resolution of escalated member or provider inquiries as related to Prior Authorization.
Works with members, providers and key departments to promote an understanding of Prior Authorization requirements and processes
EDUCATION AND TRAINING
Colorado Technical University-online
BA in Healthcare Management August 2014-present
Miami Dade Community College
Miami, Fl March 2012-Aug 2014
ADDITIONAL SECTIONS
Fluent in English and Spanish
Proficient in MS Word, Excel and Powerpoint
Computer Skills for the Workplace certificate 2012 Full Name
Phone number or email Page 2 of 2
Miami, Fl March 2012-Aug 2014
ADDITIONAL SECTIONS
Fluent in English and Spanish
Proficient in MS Word, Excel and Powerpoint
Computer Skills for the Workplace certificate 2012
Contact this candidate