Maria Vidana Quintero
Phoenix
Summary
Highly motivated Provider Services Representative with strong work ethic and adaptability. Skilled at working independently, quickly mastering new systems, and completing tasks efficiently. Expertise in communication, problem-solving, and data management to ensure provider service excellence. Excels in teamwork and customer service, effectively meeting provider needs and achieving personal performance goals
Overview
9
9
years of professional experience
2017
2017
years of post-secondary education
Work History
Provider Advocate
Blue Cross Blue Shield of Arizona
Phoenix
01.2024 - Current
- Verified patients insurance coverage, including eligibility, benefits and authorizations for medical services
- Assist healthcare providers with appeals for denied authorizations and claims, including gathering additional information and documentation required
- Conducted call audits to ensure adherence to established guidelines and protocols
- Handled inbound provider calls accurately initiating prior authorization requests based on procedure codes.
- Maintained consistent achievement of performance metrics and quality standards receiving recognition from management
- Experienced in utilizing Outlook, Salesforce, HRP, Image Retriever, and Faxcom for daily operations.
Dispatch Operation Specialist
Amazon
11.2021 - 12.2023
- Helped meet changing demands by recommending improvements to business systems or procedures.
- Use internal systems such as AAP, Reach, Decisiv, YMS, Microsoft Excel and Outbound Dock Management on a day to day basis.
- Adjusted and created claims.
- Responded to high volume of phone and email requests to provide logistics information.
- Coordinated regular inspections of vehicles and scheduled preventive maintenance.
- Assisted in resolving customer complaints and grievances.
- Monitored flow of paperwork and directed information to appropriate departments.
- Monitored driver locations in field and solved discrepancies to keep team on-track.
Call Center Representative
Veyo
01.2021 - 11.2021
- Reported to healthcare workers for following days' pickups and further instructions along with directions to facilities.
- Handled complaints and questions, and re-directed calls to other team members.
- Followed policies and procedures such as setting up appointments, explaining in brief detail mercy care policies.
- Checked eligibility for passengers and provided general information on services.
- Assisted members with setting up medical transportation.
Teller
Bank Of The West
04.2020 - 08.2021
- Learned about customer's financial needs, established trust, and optimized sales opportunities resulting in quality customer service.
- Answered customer inquiries regarding account balances, transaction history, services charges, and interest rates.
- Maintained in-depth knowledge of bank products and services to provide appropriate recommendations to customers.
- Monitored and reported suspicious activity in line with bank security policies.
Sales Associate
Nordstrom
07.2017 - 03.2020
- Provided positive first impressions to welcome existing, new, and potential customers.
- Engaged with customers to effectively build rapport and lasting relationships.
- Helped customers locate products and checked store system for merchandise at other sites.
- Accurately processed POS transactions, returning coin, currency, payment cards, and receipts to customers.
- Contributed to team success by exceeding team sales goals.
Education
High School Diploma -
Tolleson Union High School
Tolleson, AZSkills
- Dependable and Responsible
- Problem-Solving
- Attention to detail
- Salesforce utilization
- Strong interpersonal Skills
- Adaptable to change
- Call Handling & Provider Communication
- Demonstrates initiative and performs tasks effectively
Languages
Spanish
Timeline
Provider Advocate
Blue Cross Blue Shield of Arizona
01.2024 - Current
Dispatch Operation Specialist
Amazon
11.2021 - 12.2023
Call Center Representative
Veyo
01.2021 - 11.2021
Teller
Bank Of The West
04.2020 - 08.2021
Sales Associate
Nordstrom
07.2017 - 03.2020
High School Diploma -
Tolleson Union High School