Customer Service Representative

Leticia Calderon 916-***-****

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

Summary: I’m a quick learner with a positive attitude with some good notes and training I’m able to learn new task quickly and consider myself a team player! I have lots of experience in clerical task such as answering high volume of calls,setting up appointments, and managing many task in a timely manner. Knowledgeable in providing friendly thorough customer service experience and skilled at problem solving and resolution. EXPERIENCE

Blue Shield of California (Customer Service Representative) June 3, 2024 - November 22, 2024

● Answering Members/Providers Calls in a timely manner

● Resolving Member/Provider inquiries

● Verify Providers status

● Providing Eligibility/Benefits information

● Verifying claims status

● Correspondence (provider inquiries)

Aston Carter - Blue Shield of California (Provider Inquires) July 17,2023 - May 23, 2024

● Reviewing provider correspondence

● Reviewing if cases had been overpaid or underpaid ● Verifying Claims are processed and paid correctly ● Review and solving of Overpayments, Underpayments,

Anesthesia, Obra Cases, Claimxten Denials, and more. ● Familiar with Special and Standard pricing

● Pulling Explanations of Benefits

● Familiar with Facets, Mckesson

● Responding to the inquirer with the appropriate letter and response SKILLS

● Proficient in MS Office, such

as Word Doc. Excel, Outlook,

OneNote. SpreadSheets

●Handling High Volume Calls

while multi-tasking job task

● Assisting physician with

minor office procedures

● Problem-Solving/ Written

Communication

● Taking histories and chief

complaints

● Explaining treatment

procedures, medications and

physicians' instructions to

patients

. ● Calling in prescription

refills

● Patient Charting

● Microsoft Office Suite

● Understanding of medical

office practice and procedures

● Medical Terminology

● Working with electronic

medical records

● Insurance verifications

●Analyzing Data/ Data Entry

● Quality Work

● Quick Learner with great

communicative skills

● Time Management

EDUCATION

2015-2017 McClatchy High School

2017-2018 Rio Valley Charter

Graduated: 2018

Carrington College Sacramento,

CA Medical Assisting Certificate

Program Graduated: August 2019 ●

Aston Carter - DoorDash Support (Temporary Agent, Remote) February 28, 2023- May 31, 2023

● Customer Service

● Dasher Verification

● Analyze and respond/solve Dasher requests

● 1099-NEC tax forms

● Solve Troubleshooting cases

● Trained for Tax Pod, Troubleshooting, Account Info Update Request, Top Dasher

● Experience with Salesforce, Stripe, Dispatch, Sigma systems. Aston Carter - Maximus/EDD California Unemployment Department - Fact-Finding (Temporary Agent, Remote) January 4, 2022- February 24 2023

● Analyzing claim information to determine the cause of outstanding issues

● Assessing eligibility requirements based on UI code, policies, and procedures

● Communicating with claimants and employers by phone to obtain missing information, scheduling determinations

● Handling claims within a timely manner to achieve weekly goal.

● Familiar with otech, def pro, caui project.

Northern California Spine & Rehab- Medical Assistant (Externship

–To Hire)

July 2019 – Aug 21, 2020

● Rooming patients, recording patient vital signs, histories, chief complaints, patient charting, pulling up xray’s and or films for physicians.

● Clerical Tasks, Answering high volume of calls, review and clear voicemails, scheduling appointments, faxing, scanning, records management, filing, collecting patient information. Receive mail, review, scan and file away in patients charts. Collect payments. Retrieve Medical records for subpoena request. Review and filling up providers schedules as well as making sure providers orders are in patients charts for appointment.

Academic Honors – 3.65 GPA ●

Excellent Attendance

All Maintenance, Inc. -Office Manager’s Assistant

April 2018 – July 2019

● Filing

● Setting up appointments

● Answering phone calls

● Submit payroll with ADP

● Review accounts payable / receivable

● Analyze mail and file.

● Reviewing potential candidates applications

● Attend property manager meetings as a note taker Footaction- Sales Associate

August 2016 - April 2018

● Retail,

● Customer service,

● Stocking, Assisting with inventory

● Register

Contact this candidate