Customer Service Health Care
Resume:
Maria Saucedo
********@*****.**.**
** *****’ experience in advocating health care
** *****' experience in customer service
* *****' experience in importing/EDI files
** *****’ experience in MS office, MS Word MS Excel and Power Bilingual in Spanish
PROFESSIONAL WORK EXPERIENCE
Benefit Navigator
Patient Choice Health(contract) Aug 2024-Dec 2024
•Billing Assistance & Dispute Resolution
•Insurance Coverage Clarification
•Care Coordination Support
•Benefits Enrollment Guidance
•Policy Clarification and Support
•Prescription Assistance
•Direct Liaison with Providers
•Prior Authorization Assistance
Coordinator Retirement
The Boon Group August 2021-Oct 2023
•Collection of census, plan, and client data
•Input of employer data to a pension system and setting up proper plan files
•Self-sufficient in operating day-to-day administrative systems including ASC compliance testing system, record keeping systems, departmental databases, and other document generation systems
•Primary contact between retiree and active health group, third party vendors
•Compliance Admin to provide support to plan sponsors in plan design and testing issues
•Monitoring plan activities, including contributions and distributions, for ongoing compliance with regulations
•Actively participates in departmental projects to improve processes and procedures
Cobra Admin/Benefits Ops Admin
The Boon Group May 2019-August 2021
•Generated all required COBRA Election Notices to plan participants in accordance with COBRA laws and regulations
•Coordinated communication with internal departments regarding payments and notices.
•Generated and managed daily reports, updated database with new client information as needed.
•Educated other departments on COBRA qualifications.
Cobra Specialist
The Boon Group March 2018-
May 2019
•Set up new groups, update renewals and rates into the COBRA software
•Generate COBRA notification letters.
•Prepare proof of mailing certificates for the COBRA notices.
•Post COBRA payments
•Enroll and terminate eligible COBRA members.
•Prepare OE packets and state continuation notices, handle calls and email inquiries from qualified beneficiaries, COBRA members, brokers, and account managers.
File Import/Benefit Specialist/Customer Services
The Boon Group February 2006-March 2018
•Responsible for auditing and uploading daily employee files in an accurate timely manner. • Maintained and report daily metric statistics, status reports and weekly key indicators for management
•Drafted and created policy and procedures for the rest of the team to create a more efficient working environment
•Provided clerical support
•Routinely collaborated with department managers to correct problems and improve services
EDUCATION
S.W. Texas Jr. College
Uvalde, TX
Aug 1989 to Dec 1991
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