Customer Service Representative
Resume:
Miami, FL
***************@*****.***
VERONICA PEARSON
PROFESSIONAL SUMARY
Committed professional with extensive experience in client-focused environments. Seeking positions where talents are recognized, professional growth is encouraged, and advancement is possible. Possess administrative skill: office management, answering multiple lines, interviewing clients, providing customer service, and operating various office equipment. Serving others is my mission, and upholding the highest standards of professionalism, confidentiality, and ethical principles are my goals.
SKILLS
Mortgage and banking
Strong written and verbal
communication skills.
Spanish-English translation
Knowledgeable use of Microsoft Word, Excel, and Outlook.
Inbound/Outbound customer service
WORK HISTORY
Christus Health Plan – Irving, Texas 10/2016 – 04/2024 Claims Dept. Title Third Party Subrogation Specialist
Audited medical records, transferred information to spreadsheets, and prepared documents for liens related to medical claims.
Mailed third party subrogation requests to members.
Contacted military offices, health exchanges, and Medicare regarding member liens.
Managed requests for medical lien information to attorneys and members.
Plan Member Services
Provided product information and answered questions concerning member medical benefits.
Processed claim disputes related to billing errors, audited balance billing, and processed correspondence via mail, email, and faxes for members.
Verified and returned medical identification cards to members that was forwarded from the United States Postal Service.
Supervised approximately five employees in the mail return center.
Senior Member Service Representative
Balanced billing information and searched provider choices for members.
Maintained member records, tracked return mail, and delivered misrouted mail to the correct departments.
Provided claim status to members, updated member records, tracked and returned identification cards to correct members.
Assisted members with navigating the company website and assisted with password changes.
Medix Contractor – Dallas, Texas 01/2016 - 10/2016
Member Service Representative/Medical Insurance
Provided benefit information and eligibility to members.
Checked authorization requirements and eligibility of in-network doctors and collected monthly premium payments via telephone for all eligible members.
Served as interpreter and communicator for Spanish speaking customers.
Balanced claims when providers remit incorrect bills to members.
Irving ISD – Irving, Texas 08/2015 – 10/2015
Volunteer Teacher Assistant
Assisted teacher-of-record with organizing classroom activities for elementary school-aged children.
Photocopied documents and prepared student work packets for the teacher.
Served as a Spanish interpreter for teachers, translating to conversation to Spanish speaking parents.
Assisted teacher with managing students during classroom hours.
Urban League of Greater Dallas - Dallas, Texas 01/2007 – 07/2015
Intake Eligibility Specialist
Responsibilities included answering incoming telephone calls and setting appointments for financial assistance with rent and utilities.
Completed required forms, interviewed clients, and enrolled clients into the free computer and GED classes.
Performed office duties as assigned including developing spreadsheets for
different reports, prepared purchase order, and generated monthly office reports.
Translated for Spanish speaking clients and advocating with other agencies for the purpose of acquiring assistance for clients.
Housing Counselor
Assisted clients who were below poverty level with rent and utility payments.
Provided housing counseling to clients who were in mortgage default and acted as a liaison between client and the companies.
Made pledges on client’s rental property, mortgage, and utilities services for the purpose of avoiding eviction, foreclosures, and or disconnected of services.
Prepared documents for processing client’s pledges and faxing or emailing to vendors.
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