Customer Service Relations Specialist

Ocoee, FL ***** ************@***.*** ILEANA 407-***-**** OUTLAW

Professional Summary

Dedicated and versatile Customer Relations Specialist with extensive experience across healthcare, insurance, and customer service industries. Skilled in dispute resolution, fraud prevention, payment processing, and guiding customers through complex processes with professionalism and empathy. Proven ability to build long-term client relationships, exceed performance metrics, and deliver seamless customer experiences. Bilingual in English and Spanish.

Core Skills

• Customer Relationship

Management (CRM)

• Sales & Lead Generation • Payment Processing &

Dispute Resolution

• Insurance & Medicare

Processes

• Fraud Prevention &

Compliance (HIPAA)

• Medical Billing & Coding

(CPT, ICD-10, HCPCS)

• Data Analysis & Reporting • Microsoft Office Suite • Bilingual: English & Spanish Professional Experience

Customer Relations Specialist – ConneXus

Campaigns: KnippeRx, ACI, Project Food Box 2022 – Present

• Support pharmacists in reviewing, processing, and preparing medications while ensuring HIPAA compliance.

• Enter new and refill prescriptions, complete prior authorizations, and process insurance claims for timely reimbursement.

• Provide high-quality customer service for patients and healthcare providers, addressing inquiries and ensuring secure documentation.

• Perform outbound and inbound calls to assist with billing (Duke Energy, Kia, Hyundai, Ally, etc.), payment processing, and customer troubleshooting.

• Consistently achieved top team performance metrics: calls per hour, low average handle time, and customer satisfaction ratings.

• Conducted quality assurance checks on automated pharmacy technology and maintained accurate patient profiles and prescription logs.

Education

Apopka High School – High School Diploma

May 1999

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