ANGELICA SANDOVAL
SOUTH KOREA
Summary
Detail-oriented Warehouse professional enthusiastic about building experience in Postal Services . Skilled in multitasking to deliver accurate and on-time work outcomes in fast paced environments. Excited about new challenges and contributing to business success.
Overview
9
9
years of professional experience
Work History
Senior Customer Service Representative
Optum Care Network-Monarch
IRVINE
01.2019 - 08.2022
- Serve as Subject Matter Expert for team members and internal customers.
- Handle escalated calls, resolving, complex customer issues, applying critical thinking skills, applied logic while demonstrating compassion and empathy.
- Answer incoming calls from customers and identify type of assistance customer needs (i.e benefits, eligibility, billing, payments, authorizations for treatment and explanation of benefits).
- Ask probing questions and listen actively to identify specific questions or issues
while documenting required information in computer systems. - Intervene with care providers on behalf of customer to assist with appointment scheduling or connections with internal specialists for assistance when needed.
- Assisting customers with navigating their health plan, benefits, eligibility and conducting outbound calls to health plan partners when required.
- Research complex issues across multiple databases and work with support resources to resolve customer issues. Provide education and status on previously
submitted pre-authorizations or predetermination requests. - Provide claim status and payment information to providers in timely manner
- Assist with Provider disputes and also send claims back for reprocessing when
appropriate. - Receive and record complaints and grievances following standard operating procedures and internal department workflow processes.
- Foster interpersonal relationships showing empathy and understanding towards staff and customers to build ever growing relationships
- Handled between 60-80 calls per day depending on business needs
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Quickly learned new skills and applied them to daily tasks, improving efficiency and productivity.
- Responded to internal and external requests for information.
- Adhered to company policies and government regulations regarding data oversight and confidentiality to promote overall information security.
Warehouse Fulfillment Associate
Amazon
Buena Park
11.2020 - 03.2022
- Sorted, scanned and stacked packages onto pallets to get customers order ready for delivery.
- Moved pallets and packing material to designated vacant storage areas for operational safety.
- Informed management immediately of sorting issues, conveyor problems and safety concerns.
- Maintained high-level work standard by being accurate in sorting and processing.
- Stacked items according to weights, sizes, types and picking priorities.
- Maintained cleanliness and order of conveyor belt and sorting line areas to reduce safety risks.
- Assessed and sorted items into containers or designated areas according to classification.
- Used hand-held scanner to scan data product information into pallet.
- Sorted and placed packages into designated boxes boxes with high levels of accuracy.
- Applied Occupational Safety and Health Administration (OSHA) standards for lifting, working at heights and hazardous chemical handling.
Patient Care Coordinator
Pacific Cardiovascular Associates
COSTA MESA
06.2017 - 12.2018
- Worked closely with patients to deliver excellent and direct individualized patient care.
- Worked with patients to schedule tests and procedures.
- Helped patients and their families make informed decisions through out there treatment
- Responsible for answering all incoming calls and directed callers to appropriate department
- Responsible for verification of eligibility and benefits via health plan portals ((i.e Medi-Cal, Medicare, Anthem Blue Cross/ Blue Shield, Aetna Scan
,Cigna, Scan, Tri-care, Humana, ). - Verify patients have authorizations if assigned to HMO network and verify
CPT codes approved are appropriate for visit. - Work closely with management to call on all incoming referrals in timely
manner and assist with appointment reminders when necessary. - Explained upcoming treatment preparation, instructions and other facts to patients.
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Utilized NextGen to manage and confirm patient data, such as insurance, demographics and medical history information.
- Sets priorities and deadlines adjusting flow of work to meet team and patient needs
- Participates in team huddles and team meetings to manage, plan and follow up with patient care
- Coordinated and maintained impressive office organization to keep facilities efficient, organized and professional.
- Compiled electronic patient records covering conditions, treatments and diagnoses.
- Input data into computer programs and filing systems.
- Managed over 50 patient calls per day.
Front Desk Receptionist
Coast Urological Medical Group
LOS ALAMITOS
01.2017 - 06.2017
- Greeted guests at front desk and engaged in pleasant conversations while managing check-in process.
- Answered multi-line phone system to respond to inquiries and transfer calls to correct departments and personnel.
- Used internal software to process appointments, check-ins and check-outs.
- Verify eligible and benefits before patients appointment to ensure all copays/ coinsurance are received during check in.
- Requested and received medical records before patients scheduled appointment.
- Kept accounts in balance and ran daily reports to verify totals.
- Liaised between patients and internal staff to resolve problems involving access and eligibility issues concerning medical care.
- Contacted health plans to gather information regarding copays, co-insurances, and deductible on patients behalf before procedure. Educated patient on their benefit plan information before patients upcoming procedure.
- Assist billing department with inputting new patients in systems and gather information by contacting health plans and/or network to inquire about
claim denials. - Resolved customer issues quickly and notified supervisor immediately when problems escalated.
- Assist billing department with inputting new patients demographics in system.
- Contacted health plans and/or medical networks to inquire about claims denials. Gathered information was given to claims department for processing.
- Managed over 40 patient calls per day.
Checkout Receptionist
Orthopaedic Surgery Medical Group
Santa Ana
04.2016 - 12.2016
- Maintained consistent follow-up on status of prior authorization requests.
- Scheduled, rescheduled and cancelled appointments for patients.
- Reviewed authorizations from payer to determine approved or denied items.
- Enhanced office productivity by handling high volume of callers.
- Kept patients' appointments on schedule by informing provider of patient's arrival and any delays.
- Pulled charts and prepared for doctor assessment.
- Verified eligibility and benefits to ensure insurance coverage for upcoming appointments
- Calculated estimated copay based on current insurance benefits.
- Supported office staff and operational requirements with administrative tasks.
- Submitted for prior authorization with required documentation to appropriate insurance, health plan and/or medical network.
- Organized paperwork such as charts and reports for office and patient needs.
- Ensured patients are aware of upcoming appointments and send reminders via mail or phone call.
- Checked out between 30-40 patients per day.
Teller
Banc of California
Anaheim
11.2015 - 04.2016
- Answered customer inquiries regarding account balances, transaction history, services charges and interest rates.
- Processed customer transactions promptly, minimizing wait times.
- Completed highly accurate, high-volume money counts via both manual and machine-driven approaches.
- Learned about customer's financial needs, established trust and optimized sales opportunities resulting in quality customer service.
- Educated customers on use of banking website and mobile apps.
- Identified sales opportunities and referred customers to branch partners in financial services.
- Maintained friendly and professional customer interactions.
- Executed wire transfers, stop payments and account transfers.
- Counted, verified and handled bank deposits.
- Processed customer transactions promptly, minimizing wait times.
Coffee Barista
Disneyland
Anaheim
04.2014 - 08.2015
- Brewed and served coffee, tea and other non-alcoholic drinks according to company standards.
- Maintained cleanliness and sanitation of customer-facing work area and dining room space to meet governmental and organizational safety and health guidelines.
- Cross-sold pastries and sandwiches with coffee orders, boosting customer purchases.
- Handled OLTP systems, payment processing, cash change and issuing of receipt.
- Cleaned counters, machines, utensils and seating areas daily.
- Maintained and operated espresso machines, blenders, commercial coffee brewers, coffee pots and other equipment.
- Controlled line and crowd with quick, efficient service.
- Created wide variety of hot and cold drinks in average shifts with consistently positive customer satisfaction scores.
- Prepared and stocked baked goods, sandwiches, wraps and light snacks to compliment beverage choices.
- Memorized recipes for specialty coffee beverages and seasonal offerings.
- Pleasantly interacted with customers during hectic periods to promote fun, positive environment.
- Sanitized equipment and wiped down counters and tables to prevent spread of germs.
- Maintained supply levels in counter and customer areas to meet typical demands.
- Completed daily cash audits to correctly balance drawer at end of each shift.
Education
Associate of Arts - Healthcare Adminstration
Orange Coast College
Costa Mesa, CA06.2023
High School Diploma -
Godinez Fundamental Highschool
Santa Ana, CA06.2011
Skills
- Analytical
- Patient Relations
- Critical Thinking
- Efficient and Detail-Oriented
- Issue and Complaint Resolution
- Care Management
- Administrative Support
- Teamwork and Collaboration
- Call-Handling
Languages
Spanish
Native language
Timeline
Warehouse Fulfillment Associate
Amazon
11.2020 - 03.2022
Senior Customer Service Representative
Optum Care Network-Monarch
01.2019 - 08.2022
Patient Care Coordinator
Pacific Cardiovascular Associates
06.2017 - 12.2018
Front Desk Receptionist
Coast Urological Medical Group
01.2017 - 06.2017
Checkout Receptionist
Orthopaedic Surgery Medical Group
04.2016 - 12.2016
Teller
Banc of California
11.2015 - 04.2016
Coffee Barista
Disneyland
04.2014 - 08.2015
Associate of Arts - Healthcare Adminstration
Orange Coast College
High School Diploma -
Godinez Fundamental Highschool
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