Customer Service Specialist - Department of Human Services – Food Stamps/Medicaid/LTC/TANF - Colorado Springs, CO
(2024-08)
- Assisted clients with questions regarding SNAP food benefits, Medicaid, Long-Term Care, and Temporary Assistance for Needy Families programs.
- Reviewed client information, explained eligibility requirements, and provided guidance on applications, renewals, required documentation, and case status.
- Managed a high volume of client inquiries through telephone, in-person, and electronic communication while maintaining accuracy and professionalism.
- Researched complex cases, identified discrepancies, and coordinated with eligibility workers and internal departments to support timely resolution.
- Documented client interactions and case updates accurately in state systems while protecting confidential personal and financial information.
- Explained agency policies, program requirements, deadlines, and appeal procedures in clear, understandable language.
- De-escalated challenging situations and resolved complaints with empathy, sound judgment, and a client-focused approach.
- Maintained compliance with federal and state regulations, confidentiality requirements, and departmental procedures.
- Prioritized multiple cases and time-sensitive requests while consistently meeting productivity, quality, and service standards.
- Served as a knowledgeable resource for clients navigating public assistance programs and community support services.
Medicare Customer Service Representative - Maximus - El Paso, TX
(2023-11 - 2024-07)
- Assisted Medicare beneficiaries by providing accurate information regarding eligibility, enrollment, benefits, claims, billing, and prescription drug coverage.
- Resolved complex customer inquiries while ensuring compliance with CMS regulations, HIPAA, and company policies.
- Handled a high volume of inbound calls, consistently meeting productivity, quality assurance, and customer satisfaction performance metrics.
- Researched and resolved escalated issues by coordinating with internal departments and healthcare providers to ensure timely resolutions.
- Educated beneficiaries on Medicare plans, coverage options, and available resources to support informed healthcare decisions.
- Accurately documented customer interactions and case resolutions in multiple systems while maintaining confidentiality and data integrity.
- Demonstrated strong problem-solving, active listening, and conflict resolution skills to deliver exceptional customer service in a fast-paced environment.
- Recognized for maintaining high-quality standards, professionalism, and efficiency while meeting key performance indicators (KPIs). Ensured compliance with Medicare regulations.
Mental Health Technician - El Paso Behavioral Health System - El Paso, TX
(2022-07 - 2024-07)
- Provided direct care and emotional support to patients experiencing behavioral health and psychiatric challenges in a structured clinical environment.
- Monitored patient behavior, safety, and overall well-being and promptly reported significant changes to nurses and clinical staff.
- Assisted patients with daily living activities while promoting independence, dignity, and treatment-plan compliance.
- Conducted safety checks and maintained a secure, therapeutic environment in accordance with facility policies and regulatory standards.
- Used de-escalation and crisis-intervention techniques to manage challenging behaviors and reduce safety risks.
- Documented patient observations, incidents, and care activities accurately in electronic medical records.
- Collaborated with nurses, physicians, therapists, and other healthcare professionals to support individualized treatment goals.
- Maintained patient confidentiality and complied with HIPAA, infection-control, and behavioral health procedures.
Social Media Ads Moderator (TikTok) - Teleperformance USA - Remote
(2020-07 - 2022-07)
- Reviewed and moderated high volumes of user-generated advertising content to ensure compliance with TikTok community guidelines, advertising policies, and legal requirements.
- Applied critical thinking and sound judgment to evaluate sensitive, complex, and time-sensitive content while maintaining accuracy and productivity standards.
- Identified policy violations, escalated high-risk content, and documented findings according to established procedures.
- Maintained strict confidentiality and safeguarded sensitive user information in compliance with company policies and data privacy standards.
- Adapted quickly to evolving platform policies, workflow updates, and quality expectations in a fast-paced, metric-driven environment.
- Collaborated with cross-functional teams to improve content quality, consistency, and operational efficiency while meeting daily performance goals.
- Consistently achieved quality and productivity targets in a high-volume environment requiring attention to detail and sound decision-making.
Patient Account Representative - El Paso Orthopedic Surgery Group - El Paso, TX
(2015-05 - 2018-03)
- Managed patient accounts by verifying insurance eligibility, processing authorizations, and resolving billing and claims issues.
- Assisted patients with billing inquiries, payment arrangements, and account balances while delivering exceptional customer service.
- Processed insurance claims, followed up on unpaid claims, and coordinated with insurance carriers to ensure timely reimbursement.
- Maintained accurate patient records and documented account activity in compliance with HIPAA and organizational policies.
- Collaborated with physicians, clinical staff, and insurance providers to resolve account discrepancies and support continuity of patient care.
- Collected patient payments, posted transactions, and reconciled accounts to ensure financial accuracy.
- Reviewed medical documentation and insurance information to support accurate billing and claims processing.
- Managed multiple priorities in a fast-paced healthcare environment while maintaining accuracy, professionalism, and high-quality service.
Office Manager/Tax Preparer - Liberty Tax Service - Las Vegas, NV & El Paso, TX
(2014-01 - 2016-04)
- Directed daily office operations while preparing individual and small business federal and state tax returns, ensuring accuracy, efficiency, and compliance with federal, state, and company regulations.
- Recruited, hired, trained, coached, and supervised office staff, fostering a collaborative, high-performing team and delivering exceptional customer service.
- Managed payroll, scheduling, bookkeeping, accounts receivable, budgeting, and financial reporting to support operational and financial goals.
- Interviewed clients, reviewed financial documents, identified eligible deductions and tax credits, and advised on tax laws and filing requirements.
- Utilized professional tax software to prepare, review, and electronically file tax returns while maintaining confidential client records.
- Assisted clients with IRS correspondence, audit support, and resolution of tax-related issues.
- Developed office procedures that improved workflow efficiency, monitored performance metrics, and helped achieve revenue and productivity goals.
- Planned marketing and community outreach initiatives, resolved escalated customer concerns, and built long-term client relationships through outstanding service.
Team Leader – (BCBS of California) Customer Service Call Center - HGS - El Paso, TX
(2013-06 - 2015-05)
- Led and coached a team of customer service representatives, ensuring consistent achievement of quality, productivity, and customer satisfaction goals.
- Monitored daily performance metrics, including call quality, adherence, and productivity, and provided coaching to improve individual and team performance.
- Conducted new hire training, ongoing development to build a knowledgeable and high-performing team.
- Resolved escalated member inquiries involving health insurance benefits, claims, billing, and eligibility while maintaining compliance with HIPAA and company policies.
- Performed regular performance evaluations, delivered constructive feedback, and implemented performance improvement plans when needed.
- Collaborated with management to identify workflow improvements, increase operational efficiency, and enhance customer experience.
- Scheduled staff monitored attendance and ensured adequate coverage to meet service level agreements in a high-volume call center.
- Recognized for fostering a positive team environment through effective communication, employee engagement, and accountability.
Donor Processor - Biomat USA (Grifols Plasma) - Las Vegas, NV
(2012-10 - 2013-09)
Performed donor registration, eligibility verification, and medical history screening while ensuring compliance with FDA regulations.
