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Call Center Customer Service

Apple Valley, CA
September 27, 2023

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(Palmdale, CA)


Microsoft Office: Word, Excel, Access, Power Point and Outlook

Data Entry 10 key, 40 WPM

Familiarity of CPT, ICD, and HCPC codes

Insurance Verification

Knowledge of Medi-Cal and Medicare

Programs used Nexgen, Iseries, Hogan, Citrix, Rgh (etc)


G.E.D., Rowland Adult Community School Rowland Heights, CA 2012

Medical Billing/coding certification Bassett Adult school 2011


Gap Reason: Covid-19 and Maturity leave

Mile High Cure - Pomona, CA Jan. 2019- Mar. 2020


Ran the production line and shipping and receiving .

Verified product and confirm orders.

Call center environment and driver.

Super Care Health - City Of Industry, CA Aug. 2016 – Nov. 2016

Pharmacy Care Specialist

Inbound call center.

Verified health benefits and active insurance.

Submitted prior authorization for medical supplies to health plan.

Collected documentation from primary care ( i.e. Rx, chart notes, Dx).

Dropped claim to bill health plan or patient.

Data entry created new profiles for new patient entered all demo graphics and attached proper documents.

Follow ups with patient and Dr. office to expedite orders.

Drop shipped orders schedule delivery.

Epic Hearing (temp Aerotek) - Pomona, CA Jan. 2016 - Feb. 2016

Customer Service Representative

Verified healthcare eligibility and benefits.

Submitted referrals to providers office for patient to be seen.

Submitted prior authorization to insurance.

Verified correct procedure codes for billing.

Bank of America (Temp) - Brea, CA Aug. 2015 – Jan. 2016

Customer Service Representative II

Handled over 100 inbound and outbound calls a day in a fast paced call center environment.

Managed all complex issues to ensure each situation was handled appropriately.

Collected on defaulted accounts to bring them current.

Resolved customer complaints using empowerment skills to avoid escalation to upper management.

New Century Health (Temp) - Brea, CA Jul. 2015 - Aug. 2015

AR Representative

Flagged a high number of accounts and reviewed for accuracy.

Input the correct CPT, ICD, and HCPC codes for procedures.

Noted the correct procedure codes to get insurances billed correctly for retro payment.

Verified all information was correct to bill proper insurance.

Verified members Medi-Cal and Medicare coverage.

Insurance verification.

Inland Empire Health Plan (Temp) - Rancho Cucamonga, CA Apr. 2015 – Jun. 2015

Data Entry Clerk

Searched through records ensuring accuracy.

Input and updated members demographics into company's database.

Utilized Spreadsheets to document customer account details.

Utilized outlook to send emails to different insurance companies.

Cardinal Health - Ontario, CA Jun. 2014 - Jan. 2015

Customer Service Representative

Handled over 100 inbound and outbound calls a day in a fast-paced call center environment.

Applied ICD, CPT, and HCPCS codes for medical supplies.

Utilized Spreadsheets to keep track of daily stats.

Searched through records ensuring accuracy.

Managed all complex issues to ensure each situation was handled appropriately.

Resolved customer complaints.

Verified that all information was correct for billing.

Collection Technology - Rancho Cucamonga, CA Feb. 2013 - Jun. 2014


Made minimum of 100 outbound daily calls.

Skip traced to locate borrowers.

Set borrowers up on repayment plans, collecting on defaulted loans.

Trained new employees.

Took escalated calls from co-workers.

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