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Yyyyyy x. yyyyyy

7917 S. 41st Dr. Laveen, AZ 85339 714-721-4494

Summary of Qualifications


  Bilingual (English and Spanish) healthcare leader with nine years of valuable, hands-on experience with patients.

  Promoted to positions of greater responsibility for consistently exceeding performance objectives.

  Problem solver, with a unique ability to diffuse conflict and find favorable solutions or outcomes.

  Earned an award for customer service excellence as a result of providing outstanding telephone assistance.

  Gained the trust, confidence and respect of management to train new employees.

  Proficient with Microsoft Outlook, Word and Excel; Facets; AS400; BVIS; ISET; VAS-IDRS-CDX-Prime; Nice; Clientele; EB System; Premium Billing; iAdmin; and iElect.

  Planning to enroll in college in the Spring of 2018.

Professional Experience


Vision/Dental Resolving Analyst, United Healthcare July 2008-Present

  Analyze and resolve appeals, complaints, inquiries and grievances regarding dental and vision plans.

  Communicate effectively over the telephone with members as well as personnel at dental and vision offices.

  Educate members and providers about their contract, benefit limitations, exclusions and maximums.

  Document notes in ETS for each case reviewed, including requesting records from providers as needed.

  Train, mentor and coach new employees on best practices of operations.


Human Resources Assistant, Adecco Jan. 2008-July 2008

  Performed background checks of candidates for employment opportunities.

  Filed documents and invoices for medical, dental, LTD, STD, AD&D and life insurance.

  Telephoned carriers to resolve issues regarding employees getting claims paid.

  Inputted new employees into the payroll system.


Human Resources Coordinator, Secova Power by Ultralink Aug. 2007-Dec. 2007

  Enrolled new hires, re-hires and call carriers to update an employees coverage and also explained medical, dental and vision plans to employees.

  Provided rates of all plans that employers offer to employees, including eligibility requirements.

  Worked closely with carriers if employees were having difficulty getting claims paid.


Customer Service Representative III, PacifiCare Dental/United Healthcare 2003-2007

  Promoted from Customer Service Representative to Customer Service Representative II and then Customer Service Representative III, each promotion within one year.

  Earned an award for customer service excellence as a result of providing outstanding telephone assistance.

  Gained the trust, confidence and respect of management to train new employees.

  Resolved disputes by telephoning dental offices to correct co-pays and documented notes in Facets.


Customer Service Representative, Adecco Employment Agency (PacifiCare) 2002-2003

  Delivered stellar communication skills to customers while speaking over the telephone.

  Educates customers about dental plans, including exclusions and limitations of the plan.

  Telephoned dental care providers in an attempt to retrieve documents.


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