Customer Service Representative II - Elevance Health - Houston, Texas
(2021-08)
- Manage 40-60 daily provider and member interactions by researching eligibility, benefits, medical claims, and prior authorizations, consistently meeting quality, productivity, and attendance goals while delivering exceptional customer service
- Investigate complex healthcare inquiries using Compass, Facets, MACESS, Genesys Cloud, and Knowledge Management resources, ensuring HIPAA compliance and timely issue resolution
- Document detailed claim outcomes across multiple enterprise healthcare systems, maintaining data accuracy and supporting seamless continuity of care
- Collaborate with cross functional departments to resolve eligibility and claims discrepancies, strengthening provider relationships through analytical problem solving and effective communication
- Utilize Microsoft Excel, Outlook, Teams, and SharePoint to coordinate workflows, organize documentation, and support daily healthcare operations
- Earn consistent recognition for maintaining documentation accuracy, delivering high quality service, and providing customer focused solutions
Dental Assistant - Alexandra Garcia, DDS - Houston, Texas
(2019-02 - 2021-08)
- Assisted the dentist in delivering comprehensive patient care by preparing treatment rooms, sterilizing instruments, and supporting a variety of restorative and preventive dental procedures while maintaining OSHA and HIPAA compliance
- Collected and documented patient medical histories, vital signs, digital radiographs, and dental impressions to support accurate diagnoses and treatment planning
- Educated patients on oral hygiene, post operative care, and preventive dental practices, improving patient understanding and promoting long-term oral health
- Coordinated clinical workflows by preparing treatment materials, maintaining infection control protocols, and ensuring operatories were fully equipped for efficient patient care
- Built positive relationships with patients by providing compassionate support before, during, and after procedures, contributing to a comfortable and professional patient experience
Dental Assistant - iCare Dental, DDS - Meadows Place, Texas
(2014-08 - 2018-10)
- Delivered comprehensive clinical and administrative support for a busy multi specialty dental practice by coordinating patient intake, insurance verification, appointment scheduling, billing, and treatment preparation, contributing to efficient daily operations
- Verified insurance eligibility, monitored prior authorization requests, and assisted with claims follow up to support accurate reimbursement and minimize delays in patient care
- Assisted dentists in general, pediatric, periodontal, and oral surgery procedures while obtaining digital radiographs, documenting patient information, and maintaining OSHA and HIPAA compliant infection control standards
- Managed patient recall systems, coordinated follow up appointments, and fostered positive patient relationships through compassionate communication and exceptional customer service
- Processed patient payments, maintained accurate documentation, and collaborated with providers and office staff to ensure seamless clinical workflows and a positive patient experience
Administrative Assistant - Empire State Orthopedics, PLLC - Bronx, New York
(2011-05 - 2013-01)
- Supported daily administrative and financial operations for an orthopedic practice of approximately 80 - 87 employees by partnering with the Chief Financial Officer to maintain efficient business operations
- Coordinated credentialing and insurance enrollment for five healthcare providers, communicating directly with insurance carriers to maintain accurate records and timely provider participation
- Processed invoices, bookkeeping records, banking documentation, and high volume data entry, supporting financial reporting accuracy and operational efficiency
