Jreighlen Soares
Ventura,CA
Summary
Motivated and hardworking individual seeking to gain valuable work experience while pursuing my educational and career goals. Eager to excel in diverse work environments through dedication, perseverance, and a strong work ethic. Committed to contributing positively to a team, developing new skills, and delivering exceptional results.
Overview
13
13
years of professional experience
Work History
Customer Service Representative
Teleperformance
Hawaii
08.2024 - Current
- Managed high-volume inbound calls, addressing customer inquiries and concerns regarding medical services. I take about 30-40 calls a day, depending on my work flow and if I need to do any call backs to follow with with a patient.
- Educated patients on insurance processes, benefits, and claims submission to enhance understanding and compliance.
- Collaborated with healthcare providers to resolve patient issues efficiently, ensuring a seamless service experience.
- Resolved escalated customer complaints efficiently while maintaining composure under pressure situations.
- Remained aware of provider schedules and scope of practice on an evolving basis to organize and schedule appropriate care.
- Assisted with medical grievance with members due to services that member received from providers office and the transportation department.
- Demonstrated respect, friendliness, and willingness to help wherever needed.
- Assisted with day-to-day operations, working efficiently and productively with all team members.
- Passionate about learning and committed to continual improvement.
- Collaborated with multidisciplinary teams to enhance patient outcomes and coordination of care.
- Utilized electronic health record systems to maintain accurate patient documentation and records management.
- Advocated for patients' needs while navigating healthcare system complexities effectively.
- Analyzed billing data to identify trends and implement corrective actions for continuous improvement.
- Implemented quality assurance measures, enhancing the reliability of billing documentation and reporting processes.
- Verified insurance of patients to determine eligibility.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Managed appeals process for denied claims, resulting in successful reimbursements from insurance companies.
- Ensured timely payments from insurance providers through submission of accurate and complete claims.
Medical Assistant
Perlman Clinic
San Diego, CA
11.2020 - 11.2024
- Coordinated patient appointments and managed electronic health records to enhance operational efficiency.
- Assisted healthcare providers in conducting physical exams, ensuring accurate patient assessments.
- Obtained client medical history, medication information, symptoms, and allergies.
- Built strong relationships with patients through effective communication skills that foster trust in the clinic''s commitment to quality care.
- Ensured patient safety and comfort during examinations, effectively addressing concerns and answering questions.
- Coordinated patient referrals to specialists or other healthcare providers as needed for comprehensive care management plans.
- Optimized appointment scheduling processes to minimize conflicts and maximize physician availability for patients.
- Assisted telemedicine providers with prior authorization for weight loss medication.
- Assisted with billing and coding processes, ensuring accurate insurance claims and patient invoicing.
- Enhanced team communication by organizing regular staff meetings and sharing updates on patient care protocols.
- Conducted patient follow-up calls to monitor treatment progress and answer any questions.
- Answered telephone calls to offer office information, answer questions, and direct calls to staff.
- Obtained and documented patient medical history, vital signs and current complaints at intake.
- Processed insurance claims and verified patient eligibility for services efficiently.
- Checked patient insurance, demographic, and health history to keep information current.
- Helped patients complete necessary medical forms and documentation.
- Coordinated patient scheduling, check-in, check-out and payments for billing.
Customer Service Representative
HMSA, Hawaii Medical Service Association
Honolulu, HI
10.2019 - 02.2021
- De-escalated problematic members concerns, maintaining calm, friendly demeanor
- Fielded member and provider complaints and queries, expediting resolutions to enhance satisfaction.
- Delivered attentive service to new and long-standing members and providers, addressing concerns and implementing effective solutions.
- Asked probing questions to determine service needs and accurately input information into electronic systems.
- Conducted outbound calls to gather account information from members. to obtain account information.
- Made outbound calls to obtain account information.
Retail Associate
Target
Kapolei, HI
11.2019 - 01.2021
- Welcomed customers, offered to help locate items and suggested merchandise without being intrusive or pushy.
- Welcomed customers, assisted in locating items, and suggested merchandise in a respectful manner to enhance shopping experience.
- Assisted customers by phone regarding store operations, products, promotions and orders.
- Arranged merchandise for display to highlight new styles, attract customers and enhance sales.
- Calculated pricing, applied discounts and collected payments to process transactions.
- Processed merchandise returns and exchanges for customers to refund payments, trade items and offer store credit.
- Maintained current store, product and promotional knowledge to drive consistent sales.
- Kept calm and applied strong problem-solving and interpersonal skills to resolve conflicts.
- Prevented store losses using awareness and attention to detail to detect gaps for corrective action.
- Handled cash, check, credit and automatic debit card transactions with 100% accuracy.
- Maintained up-to-date knowledge of store products and promotions to effectively assist customers and support sales efforts.
- Assessed assigned areas and displays to maintain presentable condition, restocking and reorganizing merchandise.
- Assessed assigned areas and displays to maintain presentable condition, restocking and reorganizing merchandise as needed.
- Monitored store environment to identify and address potential loss prevention issues through careful attention to detail.
- Organized store by returning merchandise to proper areas and restocked displays.
- Helped customers sign up for loyalty programs and submitted completed paperwork.
- Crossed trained in different departments.
- Cross-trained in different departments.
Home Health CNA
Metro Care
Waipahu, HI
10.2013 - 01.2016
- Supported daily living activities by serving meals, feeding, ambulating and turning over and positioning patients.
- Assisted patients with daily living activities, including meal service, feeding, ambulation, and repositioning to enhance comfort and well-being.
- Documented information in patient charts and communicated status updates to interdisciplinary care team.
- Safeguarded patient privacy with strict adherence to HIPAA protocols.
- Collaborated with diverse coworkers to achieve shared goals and resolve health-related issues for members.
- Prioritized and organized tasks to efficiently accomplish service goals.
- Juggled multiple projects and tasks to ensure high quality and timely delivery.
- Examined members' daily journals to ensure accurate documentation and facilitate care.
- Assisted approximately 10 clients with their daily living needs, including personal care and support.
Medical Assistant
Island Pediatric Associates
Hilo, HI
08.2014 - 01.2015
- Interviewed and engaged patients to obtain medical history, chief complaints and vital signs.
- Relayed patient messages to physicians regarding concerns, condition updates, and refill requests to ensure timely treatment.
- Performed preliminary physical tests to accurately record results in patient history summary.
- Relayed messages from patients to physicians about concerns, condition updates or refill requests to facilitate treatment.
- Scheduled appointments for patients via phone and in person.
- Prepared treatment rooms for patients by cleaning surfaces and restocking supplies.
- Organized charts, documents and supplies to maintain team productivity.
- Secured patient information and maintained patient confidence by completing and safeguarding medical records.
- Maintained inventory and tracked vaccination and product expiration logs to support compliance and patient care.
- Collaborated with local pharmacies to address and resolve patient medication issues, enhancing treatment continuity.
- Followed principles of asepsis and infection control to meet patient safety guidelines.
- Efficiently performed insurance verification and pre-certification and pre-authorization functions.
- Maintained accurate inventory records of vaccines to ensure availability for patient administration.
- Administered vaccines to patients based on their medical needs.
Education
High School Diploma -
Keau High School
Keau, HI05-2008
Bachelor of Arts - Nursing
University of Hawaii At Hilo
California, VAAssociate of Arts - Liberal Arts
Hawaii Community College
Hilo, HI05-2014
Skills
- Customer communication
- Medical billing
- Inbound and Outbound Calling
- Report writing
- Data evaluation
- Microsoft Office expertise
- Inventory management
- Facility coordination
- Business development understanding
- Problem-solving abilities
- Adaptive team player
- Product organization
- Call center operations
- Dispute resolution
- Coordination
- Stock management
- CRM software proficiency
- Written and oral communication
- Complaint resolution
- Quality assurance
- Customer needs assessment
- Eligibility determination
- Database management
- CRM navigation
- Problem-solving
- Time management
- Problem-solving skills
Timeline
Customer Service Representative
Teleperformance
08.2024 - Current
Medical Assistant
Perlman Clinic
11.2020 - 11.2024
Retail Associate
Target
11.2019 - 01.2021
Customer Service Representative
HMSA, Hawaii Medical Service Association
10.2019 - 02.2021
Medical Assistant
Island Pediatric Associates
08.2014 - 01.2015
Home Health CNA
Metro Care
10.2013 - 01.2016
Associate of Arts - Liberal Arts
Hawaii Community College
High School Diploma -
Keau High School
Bachelor of Arts - Nursing
University of Hawaii At Hilo