Service Representative Customer
Resume:
Jesse Garcia
El Paso, TX *****
*******@*****.***
Professional Summary
• Highly dedicated Customer Service and Healthcare professional with over 10 years of experience
Fully bilingual in English and Spanish
• Knowledge of Medical terminologiy
• Comprehensive knowledge of procedures and governmental regulations of financial industries with a proven ability to communicate effectively both in verbal and written capacities.
• Handled inbound and outbound calls in call center environment
• Excellent communication skills and proficiency in MS Office suite and various CRM databases.
Skills
• Medical Office Management / Customer Service
• Dependable, detailed oriented, able to grasp new concepts quickly.
• Knowledgeable in Electronic Medical Records/custom medical environment software
• CPT / ICD coding
• Insurance and benefits verification
• Patient Scheduling/Appointment
• Medical Charts and records experience while at Anthem
• HIPPA
• MS office/ Word/ Excel/ Power point
• Pre- authorization / Medical Insurance
• Transportation Coor /dination (Liason with Access to Care - at least 3-4 years)
Previous training of students in technical field and Public shcool environment (12 Years)
Curricculum development
Education
• Associate of Arts in Business Administration, El Paso Community College - 1975 to 1977
University of Texas El Paso - No Degree but attended 2 years
Work Experience
Maximus- Department of Education
September 2022 - Present
Customer Service Representative
Currently in training for Student Aid Programs
Anthem- El Paso, Texas Now known as ELEVANCE
April 2015 to June 2022
Medical Management Specialist / Customer service
• Handled Inbound /Outbound calls with members enrolled in Medicare /Medicaid programs and medical providers.
• Assisted member’s/case managers and providers with authorizations.
• Insurance and benefits verification.
• Medical Records reviews and research
Assisted members with appointment setting.
• Responded to customer questions via telephone and written correspondence regarding insurance benefits, provider contracts, eligibility and claims.
• Completed COC for new members or members transferring thru MOC.
• Responsible for Documentation of all interaction and report generating.
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