KENNY Y. PEDRAZA

• Working Full-Time on the frontline as a Specialty Benefits Advocate for Insured Members, Doctors, Nurses, Brokers, Attourneys, Employers, Other Insurance Representatives and Internal Advocates
• Responsabilities include: Handling Phone Calls, Claims, Appeals and Grievances, Clinical Documents, Certificates of Coverage, Coordination of Benefits, Recovery letters, Provider Listings, Escalations and other Correspondence
• Working with Protected Health Information, and Accesing Extensive Database for Information regarding Company Policies and Industry Accepted Medical Guidelines
• Consistently Perfect Quality Scores since date of Employment as of March 2024, Perfect Attendance and Positive Supervisor Feedback
• Assisted in Training and Coaching new Employees for Quality Assurance and Demonstrating Good Workflow

Responsible for addressing all other advocate's inquiries and assist with questions regarding product, claims, benefits, as well as clinical information.

Help in providing clarification and guiding advocates through a broad database

Assist with sending out faxes, emails, and other documents.

Verify clinical attachments like National Electronic Attachments (NEA) and other platforms.

Provide on site support to new hires and guided them through navigating and finding information and learnsources. Also assisted during training and facilitated several resources and job aids.

• Part-Time Brand Specialist With over 5 years of Experience in Customer Service and Operational Tasks, and Leading Team in Maintaining Store Visual Standards
• Responsabilities include: Handling Cash Register, Instore Online Purchases, Customer Service, Phone and Delivery Service, Order Pick Ups, Visual Tasks and Store Maintenance
• Expert and Lead in Store Shipment, Audit and Inventory Maintenance, and Extensive Operational/ Merchandise Knowledge
• Multiple Awards and Recognitions throughout the Years for Exceeding Expectations and Maintaining Brand Standards

• Working with Film, and Music Video Production for local Artists such as Daddy Yankee, Ozuna, and others
• Assisted in Catering, Handling Electrical and Camera equipment, and Actors
• Worked with Heavy Props and other Utility for Film Production
• ADR, Voice Over and Film Extra for Productions such as Transfor Ortiz Films
• Worked With Green Screen and Special Effects/ Make Up team