Summary
Overview
Work History
Education
Skills
Languages
Timeline
Generic

Pamela Toyos Pesqueira

Tucson

Summary

Customer Service Representative with background in providing exceptional support and resolving customer inquiries. Skilled in communication, problem-solving, and maintaining positive relationships with customers. Demonstrated ability to improve customer satisfaction and loyalty through attentive service and effective issue resolution. Committed to enhancing team performance by sharing knowledge and best practices in customer service operations.

Overview

16
16
years of professional experience
2026
2026
years of post-secondary education

Work History

Customer Service Representative SR (40 Hrs/Week)

United Healthcare Group
05.2024 - Current
  • Quickly and appropriately triage contacts from healthcare professionals (i.e., physician offices, clinics, billing offices)
  • Seek to understand and identify the needs of the provider, answering questions and resolving issues (e.g., benefits and eligibility, billing and payments, clinical authorizations, explanation of benefits, behavioral health)
  • Research and dissect complex prior authorization and claim issues and take appropriate steps to resolve identified issues to avoid repeat calls / messages, escalations, and provider dissatisfaction
  • Verified patient insurance coverage and benefits for medical claims.

Customer Service Advocate (40 Hrs/Week)

CITI Bank
08.2018 - 05.2024
  • Assist with evaluating and resolving service inquiries from clients across different platforms.
  • Effectively use various computer systems to complete assigned tasks and address account inquiries and payments.
  • Analyze and identify potential risks and identify solutions that meet client needs.
  • Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
  • Educated customers about billing, payment processing and support policies and procedures.

Quality Analyst (40 Hrs/Week)

MTBA
11.2012 - 07.2018
  • (Medical Transportation Brokerage of Arizona) is a transportation brokerage contracted with AHCCCS plans for the State of Arizona.
  • Submit completed reports to the member's AHCCCS Plan/Provider with corrective action plans.
  • Run weekly and monthly reports.
  • Attend monthly JOC (Joint Operations Committee) meetings.
  • (Medical Transportation Brokerage of Arizona) is a transportation brokerage contracted with AHCCCS plans for the State of Arizona.

Dispatcher (40 Hrs/Week)

Yellow Cab
02.2009 - 10.2012
  • Respond to all radio transmissions, answer all telephone dispatch calls from customers and drivers.
  • Assist drivers in answering questions and solving customer or vehicle problems.
  • Monitored vehicle locations to coordinate timely arrivals.
  • Assisted with day-to-day operations, working efficiently and productively with all team members.

Education

General Educational Development Diploma
Tucson, AZ

Skills

  • Computer Proficiency
  • Excellent Communication
  • Active Listening
  • Problem solving
  • Data Entry
  • Microsoft Excel
  • Microsoft Outlook
  • Member account management
  • Prior authorization

Languages

English (Native)

Spanish (Fluent)

Timeline

Customer Service Representative SR (40 Hrs/Week)

United Healthcare Group
05.2024 - Current

Customer Service Advocate (40 Hrs/Week)

CITI Bank
08.2018 - 05.2024

Quality Analyst (40 Hrs/Week)

MTBA
11.2012 - 07.2018

Dispatcher (40 Hrs/Week)

Yellow Cab
02.2009 - 10.2012

General Educational Development Diploma

Similar Profiles

CREATE PROFILE
Pamela Toyos Pesqueira