Customer Support Health Care

Andrés E. Salcedo

P.O. Box **** Rancho Cordova, CA 95741 213-***-**** ************@*****.***

Professional Profile

Hardworking and detail-oriented with the ability to deal with a variety of projects simultaneously; over

14 years professional analytical experience; fluent in English and Spanish; experience solving complex problems and developing alternatives; providing customer support, excellent organizing skills, reviewing, and evaluating projects; positive and constructive team-player approach; easily adaptable to changing work environments; communicate effectively both oral and in writing; ability to maintain and build great working relationships with a variety of customers; displaying great interpersonal skills; effective in stressful situations; desire to grow professionally and expand knowledge and experience in the areas of Public and Business Administration, Management Analysis, and Supportive Staff Services.

Computer Skills

MS Office Suite: Word, Excel, Outlook, Publisher, PowerPoint, SharePoint; SPSS; Internet Research Browsers; Adobe; Counseling/Clinic Related Programs; General Presentation Equipment; Clarify/Spot light/Dove Tail; and OTIS Online Complaint Lookup.

Education Bachelor of Arts: Sociology CSU, Sacramento

Professional Experience

Care Taker

Sacramento, January 2019 – Present

Acted as a Family in home care taker

Served as a Personal care assistant

Helped with Daily Living – Meal Planning/Preparation/Laundry/Grooming Assistance

Performed House Keeping Duties

Provided Medication Reminders

UPS

Delivery Assistant Sacramento, CA November 2020 – December 2020

* Sort/Loaded/Delivered a multitude packages along a designated route.

* Utilized excellent time management to sequentially prioritize the workload and distribution.

* Provided excellent customer service, prepared, and verified numerical distribution.

CA DEPT OF MANAGED HEALTH CARE

SSA Range C/AGPA: Complaint Analyst Sacramento, CA April 2018 – October 2018

Served as a Complaint Analyst that reviews, evaluated, and resolved Consumer/Enrollee (EE) complaints.

Utilized my technical, consultative, programmatic skills to help protect consumers’ health care rights.

Knowledge of the California Knox-Keene Act

Conducted research and case study analysis on complex sensitive complaint issues applying the appropriate statutory/regulatory provisions, and through careful research, discovered plan grievance violations.

Independently prepared case summaries/correspondence to health plans, EE’s, and representatives.

Collaborated with Co Team members to share trends, attended trainings for Health Plan/MG/Law Updates and assessed impact of effectives.

Maintained communication with management and senior management regarding consumer trends, topic complaints, and consumer inquiries.

CA DEPT OF MANAGED HEALTH CARE

SSA Range C: HC Analyst Sacramento, CA October 2016 – April 2018

Served as 1st Point of Contact in a contact/call center for nationwide and CA customers, providers, their staff, advocates and health plan representatives seeking information regarding health plan provisions.

Assisted customers/EE’s with their dilemma/situation and identified primary and supporting complaints.

Knowledge of CA rules and regulations (Knox-Keene Act Law). In accordance with the K-K Act, provided resource/educational information, and approach options to the customer.

Documented complaint, supporting information, complainant demographics and jurisdictional resources for employer based health plans, Individual on and off the exchange plans provided.

Provided information on COBRA/Cal-COBRA, self-insured/self-funded/fully funded plans and PPO plans.

Worked with medical professional staff, providing all relevant information as necessary to determine urgency for complaints.

Documented calls and entered information into database.

Collaborated with Co Team members to share trends attended trainings for Health Plan/MG/Law Updates and assessed impact of effectives.

Maintained communication with management and senior management regarding consumer trends, topic complaints, and consumer inquiries.

SAM’S CLUB/LOWE’S

Member Service Associate/CSR II Citrus Heights/Rancho Cordova, CA June 2016 – July 2016 and October – November 2016

Introduced and Educated Members/Non Members to the Benefits of Sam’s Club/Lowes through knowledge, service, and effective or informative communication utilizing my Bi-Lingual skills: English and Spanish.

Processed New Personal and Business Memberships/Upgrades/Returns and Credit Card Applications.

Processed member product exchanges/credit card payments/provided product referrals and Warranty information.

Used computer programs to assist member with Item look up.

Performed Inventory and Product Presentations

Operated Cash Register: balance funds with accuracy and integrity.

Followed Company, local/state/federal requirements in the selling of state taxed items.

Resolved member/customer complaints

Utilized secured and confidential computer terminal and programs to assist member with Item look up.

Performed Inventory and Product Presentations

Operated Cash Register: balance funds with accuracy and integrity.

Followed Company, local/state/federal requirements in the selling of state taxed items.

CSU, SACRAMENTO

Support Assistant Sacramento, CA July 2005 – June 2016

Initial point of contact for diverse professional and community populations (Bi-lingual: English and Spanish, hearing/visually impaired)

Developed spreadsheets memorandums, presentations, and announcements.

Researched, inputted, and analyzed large time sensitive data for various reports and management requests; analyzed data and presented information effectively.

Exercised a high degree of initiative, independence, and confidentiality in obtaining and analyzing data.

Performed Compliance review in accordance with the University Standards and Regulatory Boards.

Consulted with and advised management or other interested parties on a wide variety of subject- matter areas.

Reviewed graduate applications for multiple programs; reviewed for completeness, noted omissions and advised students accordingly; attention to detail and accuracy. Used a variety of analytical techniques to resolve problems, reasoned logically and creatively, and paid close attention of detail.

Independently developed correspondence relating to graduate requirements and general information for students and the public

Updated and edited customer service, and CSUS program policy.

Exercised a high degree of quality customer service to the public by answering questions, and returning telephone and email messages regarding the program.

Proficiency with Microsoft Windows and Office, including Word, Excel, PowerPoint, Access; Created PowerPoint presentations to illustrate data.

instruction manuals, desk reference materials, and program manuals to conform to new policies and graduate requirements.

Cross-trained with knowledge of programs and services provided by other CSUS departments, including: administrative support.

UCDHS CLINICS

Assistant II Sacramento, CA November 2003 – July 2005

Worked in a Contact/Call Center Environment where I communicated with customers regarding the ophthalmology appointment information, scheduled followed up appointments, provided accurate information to physicians so they could properly triage follow up appointments, entered their health care information into a database, and provided Administrative support member to physicians within the Ophthalmology specialty clinic.

Worked at the check in counter – took copay payments for appointments from patients, provided necessary change, ensured my drawer was accurate, check in patients and scheduled follow up appointments as noted.

Managed database and tracking; statistical analysis of clinic data relating to patient care.

Analyzed financial data and provided reports to management using Excel spreadsheets and Word documents; communicated to all levels of staff through oral presentations and report formats.

Consistently provided excellent customer service; knowledgeable of program policy and procedures.

Data entry component with a high degree of accuracy and efficiency. Medical billing duties as required.

Proofread and edited curriculum vitae information for professional and administrative staff; created professional letters and memorandums and other written materials.

Oversight and coordination of travel arrangements and reimbursements; prepared expense reconciliation.

Maintained knowledge of policies and procedures; stayed up to date on current trends and business practices.

General office duties including: communicated with customers, employees, and other individuals to answer questions, disseminated or explained information, took orders and address complaints; compiled, copied, sorted, and filed records of office activities, business transactions, and other activities; answered telephones, directed calls and took messages; operated office machines, such as photocopiers and scanners, facsimile machines, voice mail systems and personal computer.

CA DEPT OF CONSUMER AFFAIRS

Consumer Information Agent Sacramento, CA March 2001 – July 2002

Resolution agent working for an inside contact/call center.

Actively listened to callers in a professional and timely manner working towards first call resolution.

Researched and communicated information to callers professionally and effectively.

Demonstrated flexibility and performed other duties as assigned.

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