Customer Service Rep

Robert Moreno

SOCIAL SECURITY ADMIN

N Miami Beach, FL 33179

********@*****.*** 954-***-****

Looking for new career not a job.

Authorized to work in the US for any employer

WORK EXPERIENCE

Inbound Customer Service Rep

Evolent Healthcare - 01/19 to 07/2021

Responsible for inbound phone calls from healthcare providers; hospitals, clinics, doctors offices, assisting

with prior authorizations, members services i.e. verification of eligibility, plan benefits etc.

Privider Services Rep.

Simply/Anthem Health Care -miami Fl. November 2016 to January 2018

roviders; hospitals, clinics, doctors offices, assisting with

Responsible for inbound phone calls from healthcare p

plan benefits etc.

prior authorizations, members services i.e. verification of eligibility,

Verification Specialist/Customer Service

Primary Care Insurance - Plantation, FL - November 2014 to Oct. 2016

Responsibilities

do two things, verify all th

script which is attached to the Carrier's app

e insurance purchases made by our customers by way of a recorded verification

lication or assist the customer during their e-signature process.

also handle all the inbound calls assisting customers with post related issues with their insurance purchases,

update credit card information, changes to their plans. also maintain and update all the deals on our Excel

program. send out thank you emails daily. also supervisor the department of four employees, give training

in all areas of my department.

Skills Used

Excellent customer service, fast and effi

department.

cient problem resolutions. train and supervise new employees in my

Claims Processor

SOCIAL SECURITY ADMIN - Fort Lauderdale, FL - June 1994 to September 2013

and the internet to determine eligibility.

interviewed inquirers, future beneficiaries, face to face, phone

d Medicare insurance benefits. Was

for Federal benefits under Retirement, disability, survivors an

responsbile for adjudication of all benefit payments. Develope, document and resolved all

overpayments, Determine amount of excess payment and resolve by recovery,».waiver and/or

determination that the overpayment did not exit or is uncollectible. Develope and document all request for, .

appeals (Reconsideration and Hearings). Answer questions anf resolves problems concerning Medicare

pament. Pursues to completion incidents of dissatisfaction with Medicare reimbursement rates or other

practices. Provides assistance in the preparation of Medicare claims and appeal forms.

a Center Representative

IAL,

SECURITY ADMIN - Fort Lauderdale, FL - February 1991 to May 1994

Debmm tlascnm ed han anGialnci

AR

Cvntlainanad

H 8 é

woe tie. in nee Le © ob bo etn bla ee mbrieal® at sale ee inn ae ictnoank

Contact this candidate