Carmen Cruz
Bourbonnais
Summary
Personable and dedicated customer service representative, solid team player with an upbeat, positive attitude, and proven skill in establishing rapport with clients. Motivated to maintain customer satisfaction, bilingual communication, and contribute to the company's success. Articulate, enthusiastic, and results-oriented, with a demonstrated passion for building relationships, cultivating partnerships, and growing businesses. Recognized for meticulous attention to detail and a strong commitment to quality service, I thrive in fast-paced environments.
Overview
11
11
years of professional experience
Work History
Inbound Contact Representative
Clinical Care Medical Center
Miami
06.2023 - Current
- Represents the Company by addressing incoming telephone digital or written inquiries
- The inbound Contact Representative performs varied activities and moderately complex administrative operational/customer support assignments
- Perform computations
- Typically works on semi-routine assignments
- Addresses customer needs which may include complex benefits questions resolving issues and educating members
- Records details of inquiries, comments or complaints, transactions or interactions and takes action by it
- Escalate unresolve and pending customer grievances
- Decision are typically focus on interpretation of area/department policy and methods for completing assignments
- Work with defined parameters to identify work expectations and quality standards, but has some latitude over prioritization and timing, and works under minimal direction
- Follows standard policies/practices that allow for some opportunity for interpretation /deviation/and/or independent discretion
Contact Center Associate
UHealth Connect
11.2022 - 05.2023
- Company Overview: University of Miami
- Provide general information about University of Miami Health System services to patients and community health care providers
- Schedule and accurately complete full registration for patients requesting appointments with the UHealth system adhering to policies and procedures regarding appointment scheduling and registration processes, performing these tasks accurately with attention to detail to ensure the highest quality standards
- Initiate pre-registration process and coordinate with the Central Insurance Verification and Patient Access teams to assure pre-registration in the appropriate facility prior to the appointment
- Ensure all demographic insurance information is accurate, complete, and up to date on patient’s screen
- Verification of insurance information, verification of benefits, and insurance referral information
- Verification of private patient insurance information for same-day appointments or by request
- Adhere to standards provided by the HIPPA Privacy Office related to patient privacy and confidentiality
- Assure ease of patient flow through medical care process
- Complies with the written guidelines provided by the HIPPA Privacy Office related to patient privacy and confidentiality
- Provide patients with all required information regarding appointments and payment policies (e.g
- Medical records, parking, cash policies, anticipated charges, required ancillary services, cancellation policy)
- Intervene as liaison/advocate for patients, physicians, and staff in facilitating ease of care
- Assist in identifying trouble spots and problem patterns in the provision of care
- Maintain a working knowledge of medical symptoms, signs, and anatomical systems to identify and differentiate the type and urgency of medical need
- Maintain knowledge of insurance referral requirements to ensure access based on third-party reimbursement criteria
- Notify appropriate parties of the appointment time, referral criteria, insurance verification, and prior authorization requirements
- Performs all above-mentioned tasks by paying attention to detail and providing excellent customer service skills with Patients, Physicians, and other related members by following the Standard of Excellence and Accountability policy mandated by the University of Miami Miller School of Medicine
- University of Miami
Test Schedule Results Agent (TSRA) Contract
Rhode Island Department of Health (RIDOH)
Rhode Island
12.2020 - 09.2021
- Bilingual Test Schedule Results Agent serves as a primary point of contact between incoming/outbound callers and the Rhode Island Department of Health
- Use client relationship management software (Salesforce) to manage and document client caller interventions
- Assisting incoming & call back calls scheduling COVID-19 test and Vaccine appointments through state available testing sites using inContact and Salesforce applications
- Responding to inquiries resulting from COVID-19 test scheduling questionnaires or communications
- Validate and verify callers’ Personal Identifying Information (PII) prior to providing patient test results
- Provide COVID-19 test results to patients following Rhode Island Department of Health (RIDOH) protocols(scripts) and HIPA
- Escalate calls or issues to the appropriate designated staff for resolution, as needed
- Attend meetings and training, as requested, and maintain up-to-date knowledge of all programs and systems
- Meet quality assurance (QA) and other key performance metrics
- Adhere to the processes, policies, and procedures of the program, including the protection of personal health information
- Serves as Spanish Interpreter to clients
- Utilize databases and written materials to look up and provide information to telephone inquiries
Disaster Case Manager (DCM)
St. Vincent De Paul
San Juan
10.2019 - 03.2020
- Serving as a primary point of contact between designated Clients and the Organization
- Assisting the Client in planning and coordinating necessary services and resources to address the client’s complex disaster recovery needs to re-establish normalcy; encouraging and enabling the Client to play an active or lead role in their own recovery
- Using a social work model, aiding clients (maintaining confidentiality) affected by Hurricane Maria, developing empathy with disaster survivors to identify and prioritize needs, and executing short and long-term plans to achieve client needs following FEMA guidelines
- Document management of program eligibility and other required information in electronic databases and case management systems (CAN)
- Serves as Spanish Interpreter to clients as FEMA documents are in English
- Prepare letters to applicants and other required program documents
- Communicate with clients by phone, email, and in-person to communicate program requirements and case status
- Ensure all hard copy and automated files are updated and maintained in strict accordance with established policies and procedures
- Master policies and procedures governing federally funded recovery programs
- Interact with project lead and staff from local, state, and federal government agencies
- Coordinate public outreach events and off-site applicant meetings
- Provide tracking and reporting information on cases progressing from intake to closeout
- Responsible to manage 35 cases
Administrative Assistance/Receptionist
Vargas University
Pembroke
03.2018 - 09.2018
- Responsible for opening the facility, answering phones, greeting customers, filling, and drafting documents and emails as assigned
- Provide registration support to students to enroll in the Introduction to Children Developmental Associate Certification(CDA)
- Perform accounts reconciliation
- Occasionally serves as a translator
Accounting Clerk/Facilitator
PR Relocation
San Juan
02.2014 - 09.2017
- Accounting clerk
- Perform accounting financial transactions using QuickBooks
- Issue accounts receivables and payables
- Prepare Reports
- Assist relocating customers in identifying their living, and school requirements
- Work as Owners agent representing clients at the government and private sector agencies such as utilities, financial institutions, schools, etc
- Occasionally serves as a translator
- Perform house inspections for granting and closing rental agreements
Education
Bachelor Arts - Concentration: Modern Languages, French, Italian Portuguese Minor: English
University of Puerto Rico Rio Piedras
San Juan Puerto Rico Skills
- Next-Gen
- EPIC scheduling
- NICE IN Contact
- Salesforce
- Bilingual communications
- Spanish fluency
Timeline
Inbound Contact Representative
Clinical Care Medical Center
06.2023 - Current
Contact Center Associate
UHealth Connect
11.2022 - 05.2023
Test Schedule Results Agent (TSRA) Contract
Rhode Island Department of Health (RIDOH)
12.2020 - 09.2021
Disaster Case Manager (DCM)
St. Vincent De Paul
10.2019 - 03.2020
Administrative Assistance/Receptionist
Vargas University
03.2018 - 09.2018
Accounting Clerk/Facilitator
PR Relocation
02.2014 - 09.2017
Bachelor Arts - Concentration: Modern Languages, French, Italian Portuguese Minor: English
University of Puerto Rico Rio Piedras
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