LAIZA NAVARRO
Visalia,CA
Summary
Detail-oriented individual with exceptional communication and project management skills. Proven ability to handle multiple tasks effectively and efficiently in fast-paced environments. Recognized for taking proactive approach to identifying and addressing issues, with focus on optimizing processes and supporting team objectives.
Overview
14
14
years of professional experience
Work History
Customer Service Representative
Capital Staffing Solutions - Blue Shield
11.2022 - 12.2023
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Complied with HIPAA regulations regarding patient health information security.
- Prepare fax packets and via fax medical records request.
- Follow-up on failed faxes
- Maintain consistent productivity according to Dept. standards
- Filed MR fax packets in designated drive and folders.
- Ability to meet quota
- Utilize Microsoft Office; Word & Excel, Outlook, OneNote, QSHR, Facets and RightFax.
Office Assistant IV
Tulare County HHSA Child Welfare Services
10.2015 - 01.2020
- Overlooked and submitted Mental Health referrals, while assisting the Mental Health Liaison with escalating referrals.
- Executed record filing system to improve document organization and management.
- Submitted children and parent’s referrals to Mental Health providers.
- Prepared and scheduled meeting rooms with materials and recorded information.
- Daily communication with Mental Health providers to ensure referral deadlines.
- Provided clerical support addressing routing and special requirements.
Medical Biller
Advanced Digestive Medical Center
02.2015 - 05.2015
- Reviewed patient records, identified medical codes, and created invoices for billing purposes.
- Prepared billing statements for patients and verified correct diagnostic codes.
- Communicated with insurance providers to resolve denied claims and resubmitted.
- Posted payments and collections on regular basis.
- Submitted 75-85 claims daily electronically or by paper.
- Balanced all payments with bank statements and receipts.
Oximetry Specialist/Customer Service Representative
Care Medical
12.2013 - 10.2014
- Pre-qualified patients with oxygen tanks based on guideline qualifications.
- Scheduled DME technicians for home visits.
- Scheduled delivery and pick-up for oximetry device.
- Uploaded overnight oximetry records into the database.
- Faxed results to Doctor's. Office.
- Handled customer issues with confidence using problem-solving to provide effective resolution.
Customer Service Advocate
Cigna
03.2010 - 03.2013
- Advocated customers with understanding their health benefits.
- Assisted customers with locating an In-Network provider.
- Supported the call center by taking on escalating calls, handling complex concerns and achieving customer satisfaction.
- Assisted customers with appeals and resubmission of their claims.
- Met quarterly quotas.
Skills
- Bilingual- Spanish
- HIPAA compliance
- Attention to details
- Multi-phone line proficient
- 50 WPM typing speed
- Microsoft Office proficient
- Filing and data archive
- CMS-1500 billing forms
- Customer service
- Data entry
- Call center experience
- Computer proficiency
- Microsoft outlook
Timeline
Customer Service Representative
Capital Staffing Solutions - Blue Shield
11.2022 - 12.2023
Office Assistant IV
Tulare County HHSA Child Welfare Services
10.2015 - 01.2020
Medical Biller
Advanced Digestive Medical Center
02.2015 - 05.2015
Oximetry Specialist/Customer Service Representative
Care Medical
12.2013 - 10.2014
Customer Service Advocate
Cigna
03.2010 - 03.2013
Similar Profiles
STACIE KANGSTACIE KANG
Provider Credentialing Specialist - REMOTE at Strategic Staffing Solutions, Blue Cross and Blue Shield of LouisianaProvider Credentialing Specialist - REMOTE at Strategic Staffing Solutions, Blue Cross and Blue Shield of Louisiana
La Nacia VargasLa Nacia Vargas
Claims Adjuster at Catalyst Solutions Blue Cross Blue ShieldClaims Adjuster at Catalyst Solutions Blue Cross Blue Shield
Samantha SabinskySamantha Sabinsky
Staffing Coordinator at Capital Staffing SolutionsStaffing Coordinator at Capital Staffing Solutions
Monte PeckinpahMonte Peckinpah
Territory Account Manager, Crop Advisor at Abbott/Valent USATerritory Account Manager, Crop Advisor at Abbott/Valent USA
Alejandra MartinezAlejandra Martinez
Certified Pharmacy Technician at Rite-Aid PharmacyCertified Pharmacy Technician at Rite-Aid Pharmacy