Natalia Ruiz
Santo Domingo,DR
Summary
Results-driven professional looking forward to provide tailored solutions to meet company's needs. Experienced in successfully establishing relationships with customers and providing quality service. Agile individual with excellent communication and interpersonal skills. Tactful communicator with strong work ethic looking for an opportunity to become a first time home office virtual assistant, and deliver excellence in every required task.
Overview
10
10
years of professional experience
Work History
HEALTH INSURANCE ADVISOR
MAXIMUS, INC./ NEW YORK STATE OF HEALTH DEPT.
New York, NY
05.2018 - 03.2022
- Enhanced customer satisfaction by providing accurate and timely information on health insurance policies and benefits.
- Achieved consistent high levels of customer satisfaction through empathetic listening and problem-solving skills when addressing concerns or disputes.
- Resolved client inquiries efficiently through clear communication, resulting in improved customer relationships and trust.
- Assisted clients in understanding complex insurance terms and conditions, leading to better decision-making and policy selection.
- Maintained up-to-date knowledge of federal and state regulations affecting health insurance policies, ensuring full compliance during all transactions.
- Monitored changes in health insurance laws and regulations to verify continuous compliance.
- Actively listened to customers, handled concerns quickly and escalated major issues to supervisor.
MEDICAL CLAIMS CONSULTANT
TELEPERFORMANCE/BLUESHIELD OF CALIFORNIA CAMPAIGN
Santo Domingo, Dominican Republic
01.2014 - 03.2017
- Filed and processed client insurance claims
- Confirmed coverage and payment amount for each claim
- Issued explanation of benefits forms to customers
- Sent payments to doctors’ offices or hospitals for covered procedures
- Assisted new customers in signing up for health insurance coverage
- Reimbursed customers for payments made that should have been covered
- Guided customers to appeal denied claims when possible.
- Weighed benefits versus costs of approving out of network claims
- Evaluated client needs and expectations, establishing clear goals for each consulting engagement.
- Collaborated with cross-functional teams to successfully deliver comprehensive solutions for clients.
TECHNICAL SUPPORT/CUSTOMER SERVICE REPRESENTATIVE
XEROX INC/SPRINT CAMPAIGN
Santo Domingo, Dominican Republic
06.2012 - 01.2014
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Evaluated customer’s inquiries and ensured proper solution was provided
- Handled customer inquiries and suggestions courteously and professionally.
- Provided assistance to customers on how to use different mobile device platforms
- Identified and escalated priority issues per company’s specifications
- Redirected problems to appropriate resource
- Stayed current with system information, changes and updates.
Education
Associate in Science in Business Administration - Accounting
CUNY BRONX COMMUNITY COLLEGE
BRONX, NY08.2018
Skills
- Decision Making
- Critical Thinking
- Time Management
- Problem Solving
- Teamwork
- Adaptability
- Microsoft Office
- Self-motivated
- Tech-savvy
Languages
Spanish, English
Native language
Timeline
HEALTH INSURANCE ADVISOR
MAXIMUS, INC./ NEW YORK STATE OF HEALTH DEPT.
05.2018 - 03.2022
MEDICAL CLAIMS CONSULTANT
TELEPERFORMANCE/BLUESHIELD OF CALIFORNIA CAMPAIGN
01.2014 - 03.2017
TECHNICAL SUPPORT/CUSTOMER SERVICE REPRESENTATIVE
XEROX INC/SPRINT CAMPAIGN
06.2012 - 01.2014
Associate in Science in Business Administration - Accounting
CUNY BRONX COMMUNITY COLLEGE