Vicky Caballero

Results-driven bilingual customer service and healthcare billing professional with 20 plus years of experience across customer support, account resolution, claims review and operational support. Skilled in resolving complex billing issues, analyzing account histories, supporting escalations and maintaining HIPAA compliant documentation. Recognized for strong problem-solving, attention to detail, adaptability, and quickly mastering new systems.

Targeting roles in Quality Assurance, Billing Operations, Technical Support, Customer Success, or Healthcare Operations. Seeking a dynamic role where I can apply my problem-solving abilities and contribute to enhancing operational excellence.

Senior Billing Agent at Accredo Health Group / Express Scripts / Cigna (2024 – Present)

• Assist with identifying, developing, implementing, and managing relationships with prospective and existing national partners to drive strategic growth and franchise partner engagement
• Provide subject matter expertise on payor sources—including the VA, Medicare Advantage, Medicaid, long-term care insurance, workers’ comp, Copay assistance and the GUIDE Model—to provide guidance and support to both franchisees and internal stakeholders
• managing high-volume inbound patient calls with accuracy and empathy
• researching and resolving account issues using multiple systems
• delivering clear guidance and next steps
• maintaining HIPAA compliant documentation, and adapting to evolving procedures and remote workflows while meeting performance goals

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• Played integral role in improving overall team efficiency and customer satisfaction metrics overall in Customer Service
• Enhancing communication, ensuring coordinated care, promoting adherence to treatment plans
• Providing financial and emotional support, empowering individuals with education and resources
• Improving patient satisfaction and experience

Customer Experience Specialist at HCSC Blue Cross Blue Shield (2021 – 2024)

• researched and corrected claims including CPT code adjustments and resubmissions
• documented escalations
• tracked resolution progress, partnered with account managers on client communications
• quarterly reviews and renewals
• trained and mentored team members to drive consistency and compliance
• Recognized for exceptional problem-solving skills, leading to resolution of complex member issues
• Played integral role in improving overall team efficiency and customer satisfaction metrics overall in Member services, Over65 and pharmacy

Installation Manager at Closets by Design (2017 – 2021)

• Create and submit contracts, invoices and statements.
• Document case activity, communications, and correspondence into CBD System
• Provided daily support to installation personnel for seamless operations
• Scheduled jobs and services, overseeing on-site job management
• Ensure all revenue opportunities are included, and complete and submit billing to primary and secondary payers.
• Managed all aspects of installation department, ensuring smooth operations
• Oversaw accurate material loads for van deployments to job sites
• Conducted in-person surveys with customers for quality assurance purposes
• Successfully streamlined installation processes, resulting in improved project timelines and customer satisfaction
• Implemented efficient scheduling systems resulting in reduced downtime and increased productivity

HS Diploma – Memorial High School (1988 – 1992)

Bachelors in Organizational Leadership – Mountain State University (2003 – 2005)

AI in Healthcare Analytical Program - MIT 2026