Service Representative Customer

CECILIA MIRAMONTES

***** ********** **, **********, ** 91311 747-***-****

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

OBJECTIVE

To enhance my job skills in a way that will allow me to grow in the customer service fields.

EXPERIENCE

United States Postal Service

City Carrier Assistant July 2022- August 2022

Deliver and collect mail on foot or by vehicle under varying road and weather conditions in a prescribed area

Maintain professional and effective public relations with customers and others, requiring a general familiarity with postal laws, regulations, products and geography of the area

Regal Medical Group

Member Service Representative January 2018- September 2021

Assisted members, health plans and providers with authorizations, claims, and eligibility while following HIPAA.

Took a high volume of calls on a daily basis (50-65 calls per day) and document every call.

Assisted with call backs to members and to providers for daily messages received.

Use of Cisco phone agent, EZ Cap documentation/claim system, REA connect, Outlook email, Word and Excel.

Blue Shield of California

Customer Service Representative September 2013- January 2016 (temp from September- April 2014)

Assisted existing and prospective Medicare HMO plan members with their questions and concerns related, but not limited to, plan benefits, co-pays, authorization processes for both prescriptions and medical services, finding/changing providers, change of plans, special and annual enrollments/disenrollment, complaints/grievances, denials, appeals, pharmacy and medical claims, bills received from providers and access to care issues over the phone (English and Spanish calls).

Helped management with projects such as calculating the maximum out of pocket expenses for members, reviewing and verifying grievance audit spread sheets, entering member demographic info for the enrollment department, handling paper and electronic member correspondence and assisted in training new workers.

Knowledge of Microsoft Word, Excel, PowerPoint, Outlook, Documentum, Argus, AS400 and Facets.

Kidney Consultants Medical Group

Medical Assistant November 2010 – October 2012

All general office duties including, but not limited to, filing/pulling patient charts, handling heavy call volume, scheduling new and returning patient appointments, obtaining patient demographic and insurance info, authorizations, obtaining all necessary lab and radiology test results, collected co-pays, performing vitals, urinalysis, and injections.

EDUCATION

Los Angeles Pierce College Continuing Education 2011-2012 & 2013-2014

Kaplan College Medical Assistant Certificate April 2009 - January 2010

Van Nuys Adult School GED October 2008

REFERENCES

Jonathan Ketchum Regal Team Lead 1 year 818-***-****

Adrienne Fuentes Regal Customer Service Rep 2 1 year 805-***-****

Aracely Andino Regal Customer Service Rep 1 year 818-***-****

Cynthia Govea Regal Customer Service Rep 1 year 818-***-****

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