ALWIN DARIEL RIVERA ROSADO
Comerío
Summary
Developed skills in regulatory and compliance-focused environment, excelling in analytical thinking and problem-solving. Demonstrated ability to manage and resolve complex issues, ensuring accuracy and consistency in documentation. Seeking to leverage these transferrable skills in new, dynamic field to drive positive outcomes and improvements.
Overview
8
8
years of professional experience
Work History
Grievances and Appeals Technician
MCS HEALTHCARE HOLDINGS, LLC
San Juan
04.2024 - Current
- Maintained a safe work environment by strictly adhering to established safety protocols and guidelines.
- Trained new technicians on standard operating procedures, ensuring consistency across the team.
- Processed Pre-service appeals with precision, maintaining compliance with regulatory standards.
- Support with daily mailing and Payment appeals distribution email refilter.
Customer Service Representative - SC
MCS HEALTHCARE HOLDINGS, LLC
San Juan
08.2021 - 01.2024
- Service Center for customer lines MCS Classicare and MCS Life.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Offered advice and assistance to customers, paying attention to special needs or wants.
- Responded to customer requests for products, services and company information.
- Recommended products to customers, thoroughly explaining details.
- Responded proactively and positively to rapid change.
- Exhibited high energy and professionalism when dealing with clients and staff.
- Preform audit of PHI which stands for Protected Health Information. Monitoring that documentation is correct and complies with regulations
Customer Service Representative - CC
MCS HEALTHCARE HOLDINGS, LLC
San Juan
10.2018 - 04.2021
- Call Center for customer line MCS Classicare.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Answered constant flow of customer calls with minimal wait times.
- Educated customers about billing, payment processing and support policies and procedures.
- Met customer call guidelines for service levels, handle time and productivity.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
Treasurer
Inter Bayamón
Bayamón
08.2016 - 06.2018
- Active member of Capítulo Estudiantil de Microbiología.
- Community Service.
- Counseling new members
Education
Bachelor of Science - Biotechnology
Universidad Interamericana De Puerto Rico
Bayamón06-2018
High School Diploma -
Escuela Superior Juana Colón
Comerío05-2013
Skills
- Calm and Professional Under Pressure
- Building Customer Trust and Loyalty
- Fast learning
- Issue and Complaint Resolution
- Efficient and Detail-Oriented
- Leadership
- Adapting to new changes
Extracurricular Activities
Capítulo Estudiantil de Microbiología de la UIPR - Treasurer
Languages
Spanish
First Language
English
Intermediate (B1)
B1
Timeline
Grievances and Appeals Technician
MCS HEALTHCARE HOLDINGS, LLC
04.2024 - Current
Customer Service Representative - SC
MCS HEALTHCARE HOLDINGS, LLC
08.2021 - 01.2024
Customer Service Representative - CC
MCS HEALTHCARE HOLDINGS, LLC
10.2018 - 04.2021
Treasurer
Inter Bayamón
08.2016 - 06.2018
Bachelor of Science - Biotechnology
Universidad Interamericana De Puerto Rico
High School Diploma -
Escuela Superior Juana Colón
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