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Position Desired: Bilingual Customer Service Representative
Resume: YOLANDA S. DAVIS (h)757-242-4404, (c)757-407-0766 yolitadavis@gmail.com ___________________________________________________________________________ CAREER PROFILE Bi-lingual (English/Spanish) experienced professional with 10+ years of customer service experience, quality assurance and quality control including 16 years of credit and collections analysis at financial institutions and 6 years with health care insurance programs. Enthusiastic team player, well organized and detail-oriented, easily adapts to every changing environments and challenges. ___________________________________________________________________________ KEY QUALIFICATIONS Utilization Management Representative 07/2009-07/2015 Anthem Health Keepers, Inc. (formerly Amerigroup) Virginia Beach, VA • Obtained intake (demographic) information from caller. • Verified health insurance benefits and /or eligibility information, responded to telephone and written inquiries from members. • Processed health risk assessments over the phone, sent outreach letters when not able to reach members by the phone • Mailed health risk assessments to members. Bilingual Customer Care Rep Amerigroup • Managed inbound and outbound calls as customer care representative. • Adhered to Protected Health Care information, PHI in accordance to the Health Insurance Portability and Accountability Act, HIPPA and federal confidentiality regulations guidelines. • Assisted with benefit and eligibility explanation, claim issues, network changes, customer service issues and/or terminations. • Replied to inbound inquiries from potential and existing members, providers and billing agencies. • Resolved complex or escalated issues of callers by thoroughly researching cause of error. • Handled complex adjustments to claims. • Worked with other departments to resolve issues. Quality Assurance Rep / Credit Analyst / Collections Examiner 03/1992-01/2009 HSBC Card Services Chesapeake, VA • Monitored collections’ calls to ensure compliance with standard operating procedures. • Performed collection’s quality assurance to identify trends. • Collaborated with team and cross sites to harmonize quality assurance procedures. • Reviewed policies and procedures on a weekly basis to remain current with updates and changes. • Collected and followed up on a delinquent portfolio accounts in English and Spanish. • Mentored the activities of new employees. • Assisted with end of the month reports. EDUCATION: Bachelor in Marketing & Advertising, Jorge Tadeo Lozano University, Bogota, Colombia. Early Childhood Education- TCC in Virginia Beach, VA TRAINING: HEALTHCARE INDUSTRY: Records and information management- (RIM) New Horizons- Medicaid expansion Amerigroup- compliance program Medicaid and Medicare- Fraud, waste, and abuse Health Insurance Portability and Accountability Act (HIPPA) Privacy integration training Virginia Medicare/Medicaid overview Disability literacy Being an effective team player BANKING INDUSTRY: Fair and Responsible Lending Information Risk Awareness Program Privacy & Information Protecting Program Strategies for Effective Collecting

Changed at: 5/16/2016 9:17 PM Changed by: Anonymous
Created at: 5/16/2016 9:17 PM Created by: Anonymous

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