Cecilia M. Becerra

adybda@r.postjobfree.com

**** ******** ****** • San Antonio TX 78227 • 210-***-****

OBJECTIVE

My new position must allow me to utilize my extensive experience. When considering a new position, I am looking for one that will have long term stability, and a variety of challenging opportunities. I feel confident that I will be a valuable addition prepared to utilize my skills, dedication and desire to learn.

EMPLOYMENT

Centene Corporation September 17, 2018 – Present

Recruitment Agency Aerotek from February 26, 2018 through September 16, 2018 San Antonio, TX

Sr. Customer Service Representative

Respond to routine customer inquiries and complaints focusing on member retention. Welcome and educate new Medicare / Medicaid members about benefits and how to use our plans. Using TruCare application to assist routing members to case management. Provide excellent customer service constantly maintain above standard performance. Answer numerous calls in a high call volume call center. General office duties such as faxing, copying and reporting. High confident team player with strong work ethic skills.

UnitedHealth Group August 1, 2007 – October 10, 2017

San Antonio, TX

Sr. Business Analyst / Business Analyst

Provide clear descriptions of problems or issues and presenting options for resolution. Working in partnership with other internal business and system areas to ensure successful completion of project request. Monitoring project plan dates. Supporting and mentoring other team members to ensure project success. Comparing production claims and in test environment using Access Databases, UNET and COSMOS applications during quarterly and monthly releases.

Creating and uploading business process content for Customer Service in Resolution. Experience with MQC, creating high level and detailed test scripts, and participating in End to End Testing. Conducting User Acceptance Testing (UAT) while using NDB, COSMOS, HP ALM, Web Intelligence for provider and member data for testing. Resolving System Issues in the COSMOS testing environment.

Completed Projects

Reimbursement Modernization Phase 1 and Phase 2 – Team lead and Co-lead creating high level and detailed test plans through different phases.

oEncounter data routed through COSMOS successfully

oEncounter data being re-directed back to delegated provider

oEnd to End functional testing with delegated member group and correct delegated PCP assignments

oCollaborating with the system test team delivering and creating EDI claims for testing

WellMed / PHC Migration & Preferred Care Partners Migrations - Tested member and provider data set up for delegated groups, networks and panel. Collaborating with the System test team to set up the delegated PCP’s in NDB under the appropriate group, network and panel numbers. Confirmed delegated provider setup after contract created in NDB and fed correctly to COSMOS. Verified member assigned to a correct delegated PCP.

COSMOS ‘M’ Transaction Project – Tested claims which providers who had a negative payee balance owing to the plan. Created high level and detailed test plans with the Medicare Advantage and Community State member / provider data. Focus was on files with providers sending in payment to balance their account so show if a transaction was a partial payment or full payment to bring their account current. Collaborating with the system test team creating test files delivered to the finance department for validation.

UnitedHealth Group December 9, 2002 – July 31, 2007

Cypress, CA / San Antonio, TX

Customer Service Representative / Business Analyst / CSR II

Customer Service Representative - Respond to routine customer inquiries and complaints focusing on member retention. Welcome and educate new PacifiCare members about benefits and how to use our plan. Provide excellent customer service. Constantly maintain above standard performance. Cross train for both Secure Horizon and Commercial PacifiCare Plans using NICE and CSS. Mentor new hires and Piloted new customer service application with Resolution. Answer numerous calls in a high call volume call center. General office duties such as faxing, copying and reporting. High confident team player with strong work ethic skills.

Business Analyst – Provide clear descriptions of problems or issues and presenting options for resolution. Working in partnership with other internal business and system areas to insure successful completion of project requests. Monitoring project plan dates. Supporting and mentoring other team members to ensure project success. Creating and uploading business process content for customer service in Resolution / NICE.

Customer Service Representative II - Respond to routine customer inquiries and complaints focusing on member retention. Provide excellent customer service, internally and externally. Constantly maintain above standard performance. Mentor and coach new hires. Approve Claims Exception request from Customer Care Professionals, Sales and Marketing. Subject matter expert for PacifiCare Legacy product and proprietary systems including NICE

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