LESLIE MENDOZA
Aurora
Summary
Experienced client service representative with 5 years of healthcare operations experience. Strong organizational and communication skills with the ability to concurrently manage multiple business affairs. Advanced understanding of customer needs with diligent attention to detail resulting in superior customer service and high levels of client satisfaction. Trusted consultant, liaison, and colleague.
Overview
11
11
years of professional experience
Work History
Metlife
Senior Claim Administrator
08.2022 - 07.2025
- A&H Senior Claims Specialist
- Respond to customer requests via telephone or email, providing excellent Service to Metlife’s internal and external customers.
- Research requests regarding various products aspects, policy provisions, Claim status, administrative procedures and track responses to ensure completion.
- Efficiently access and navigate multiple electronic systems to provide a complete and integrated response to the customer’s inquiry or to meet customer’s needs and support overall team processes.
- Prepares correspondence to be provided to claimant and medical providers to facilitate claim review.
- Performs a variety of tasks requiring critical thinking and research skills.
- STD Claim Assignment Processor/Claim Adjuster (Previous temp from tailored management for metlife. March 2021- August 2022)
- Member of STD Catalyst Claims Team created to resolve issues resulting from conversion of legacy to new system for disability payments division.
- Adept at successfully solving complex problems and maintaining compliance.
- Liaison between client and business operations.
- Defined and implemented SOP training documentation ensuring standardized processes, expectations and reducing employee training time.
Medical Records Department
VNA Healthcare
09.2018 - 03.2019
- Served as initial contact for bilingual client calls up to 40 phone calls per day.
- Managed patient files from intake including scheduling, verifying insurance coverage, billing to patient aftercare.
- Maintained patient confidentiality and followed HIPPA guidelines.
Customer Service Manager
Walmart
09.2018 - 03.2019
- Coordinated front-end operations to provide exceptional customer service and provide leadership to associates.
- Reconciled cash drawer at each shift, accounting for errors and resolving.
Lab Tech Assistant
Doctors Data Inc.
12.2014 - 04.2016
- Facilitated concerns regarding insurance, billing, auditing, and account reconciliation.
- Accessioned new record information to update and adhere to guidelines.
- Aid with lab technician needs.
Education
Diploma - License, Certified Nursing Assistant
West Aurora High School
AuroraSkills
- Friendly, positive attitude
- Teamwork and collaboration
- Customer service
- Problem-solving
- Work ethic
- Time management
Timeline
Metlife
Senior Claim Administrator
08.2022 - 07.2025
Medical Records Department
VNA Healthcare
09.2018 - 03.2019
Customer Service Manager
Walmart
09.2018 - 03.2019
Lab Tech Assistant
Doctors Data Inc.
12.2014 - 04.2016
Diploma - License, Certified Nursing Assistant
West Aurora High School
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