Beatriz Pena
Ashburn
Summary
Professional with strong background in customer service, adept at handling client inquiries and resolving issues efficiently. Skilled in communication, problem-solving, and conflict resolution, consistently ensuring customer satisfaction. Highly adaptable, team-oriented, and results-driven, excelling in fast-paced, dynamic environments. Passionate about fostering positive customer experiences and contributing to team success.
Overview
10
10
years of professional experience
Work History
Customer Service Advocate I
Centene
05.2023 - Current
- Receives and responds to routine member and/or provider inquiries, requests and/or concerns in an accurate and timely manner
- Mitigates and prevents complaints from being escalated to resolve in initial contact
- Serves as the front-line resolution advocate on various member and/or provider inquiries, requests, or concerns
- Resolves basic problems by communicating the requested information regarding the assessment of the member or provider needs, understanding the cause, and determining if problems need to be routed to other departments for further resolution
- Maintains performance and quality standards based on established contact center metrics
- Provides customer service in a high pace contact center environment over the phone, via live chats and emails
- Documents all member or provider information and communications for quality and performance tracking through the Customer Relationship Management (CRM) applications
- Remains up-to-date and adheres to quality standards, regulation, and all other policies to ensure quality, consistency, and compliance
- Performs other duties as assigned
- Complies with all policies and standards
- Resolved customer inquiries through efficient use of CRM systems, enhancing service delivery and satisfaction.
- Mentored junior team members on best practices for customer engagement and conflict resolution strategies.
Billing Specialist
State Collection Service SBO
02.2022 - 05.2023
- Makes and answers calls in the name of the client to resolve billing and payment issues utilizing establish work queues and call pools as necessary
- Responds to requests for information by patient/account holders in a professional, thorough, explainable manner
- Assists patient on understanding statement and Explanation of Benefits.
- Acts to gain payment or arrangement of payment on behalf of the client as appropriate
- Follows client-specific protocols and policies when carrying out duties
- Investigates and responds to client enquiries as needed
- Work with insurance and patient on understanding why claims were denied or need reprocessing
- Enters and monitors payment arrangements
- Adhere to all FDCPA, FCRA, HIPPA and other applicable laws
- Processed high volumes of billing transactions accurately and efficiently.
- Resolved discrepancies in accounts through detailed analysis and effective communication.
CSR - Customer Service Representative
MAXIMUS
10.2019 - 02.2022
- Provided telephonic assistance in a new government program whose rigorous content shall not be undisclosed due to contractual obligations. Assistance included receiving and greeting caller, aiding caller
- Managed customer inquiries and resolved issues efficiently through active listening and problem-solving skills.
- Provided training and mentorship to new team members to enhance service delivery standards.
Emergency Dispatcher
Brownsville Police Department
07.2019 - 10.2019
- Answered all emergency and non emergency calls. Communicated with officers and medics.
- Coordinated emergency response efforts between multiple agencies to ensure timely assistance.
- Monitored real-time data feeds to provide situational awareness during emergencies.
- Developed and maintained accurate incident logs for compliance and reporting purposes.
- Managed high-volume incoming calls, assessing critical situations and prioritizing dispatches.
Customer Service Representative
MAXIMUS
09.2015 - 03.2016
- Provided telephonic assistance in a new government program whose rigorous content shall not be undisclosed due to contractual obligations. Assistance included receiving and greeting caller, aiding caller throughout the length of the phone call, and eventually resolving caller's problem.
Education
High School Diploma -
IDEA Frontier College Prep
Brownsville, TX06-2013
Skills
- Call center experience
- Data entry
- Administrative support
- Data collection
- Computer proficiency
- Microsoft outlook
- Multi-line phone talent
Languages
Spanish
English
Timeline
Customer Service Advocate I
Centene
05.2023 - Current
Billing Specialist
State Collection Service SBO
02.2022 - 05.2023
CSR - Customer Service Representative
MAXIMUS
10.2019 - 02.2022
Emergency Dispatcher
Brownsville Police Department
07.2019 - 10.2019
Customer Service Representative
MAXIMUS
09.2015 - 03.2016
High School Diploma -
IDEA Frontier College Prep
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