Nashelle Delgado
Colorado Springs
Summary
Skilled in General Medical Admin Duties and renowned for exceptional customer service, I excelled at Anthem Inc., enhancing member satisfaction through efficient problem resolution and service delivery. Leveraging Microsoft Office and Citrix, I adeptly managed high call volumes, achieving significant improvements in member engagement and support. My proactive approach and ability to collaborate effectively drove notable achievements in member care coordination.
Overview
12
12
years of professional experience
1
1
Certification
Work History
Customer Service Representative
Luminare Health
09.2022 - 01.2025
- Provide services and support to members with self-funded health plans
- Respond to telephone, email and electronic requests from employees, members, clients, and providers
- This includes medical, dental, and behavioral health benefits, claims status and payment information
- Handle call volume and document all inquiries utilizing and navigating multiple internal systems
- Collaborate with support team to address and resolve issues and concerns
- Follow up when needed to establish resolution and customer fulfillment
Engagement Specialist
Somatus Kidney Care
03.2021 - 07.2022
- Perform telephonic outreach to members to enroll them into the care coordination program and facilitate initial interactions with the care team
- Responsible for answering incoming calls and assisting care team members with engagement and scheduling
- Other duties include assisting with requesting medical records from medical providers and uploading into the member's chart
Member Support Specialist
Colorado Community Health Alliance
01.2018 - 01.2020
- Assist members with finding behavioral and physical health provider referrals and community resources
- Answer phone calls and email inquiries and requests from members
- Partner with internal and external operational teams to resolve all inbound and outbound member requests
- Respond to customers in a professional, friendly, and timely manner to enhance our members' knowledge and ensure a positive experience
- Conduct outbound calls to educate members about available services included with Health First Colorado benefits, and provide referrals as needed
- Manage sensitive issues while maintaining the highest level of professionalism
- Recommend solutions to complex or escalated situations through research and critical thinking
- Assess members to refer to care coordination services
Customer Service Representative II
Anthem Inc.
01.2013 - 01.2018
- Respond to customer inquiries by telephone or e-mail to provide non-technical problem resolution
- Resolve mostly routine and some non-routine, more complex problems and communicates solution or requested information to the customer
- Analyze a customer's service needs and refer to other service or technical departments for follow up as needed
Education
Internship -
PRIMARY CARE ASSOCIATES
01.2011
Medical Administrative Assistant -
PIMA MEDICAL INSTITUTE
01.2011
General Studies -
Widefield High School
Colorado Springs, CO01.1999
Bachelor of Science - Health Information Technology
University of Arizona Global Campus
Arizona City, AZCertificate - Creative Writing
Full Sail University
Winter Park, FLSkills
- General Medical Admin Duties
- Customer Service
- Microsoft Office
- Management
- Call Center
- Citrix
References
Available upon request.
Certification
- Medical Administrative Assistant
Timeline
Customer Service Representative
Luminare Health
09.2022 - 01.2025
Engagement Specialist
Somatus Kidney Care
03.2021 - 07.2022
Member Support Specialist
Colorado Community Health Alliance
01.2018 - 01.2020
Customer Service Representative II
Anthem Inc.
01.2013 - 01.2018
Internship -
PRIMARY CARE ASSOCIATES
Medical Administrative Assistant -
PIMA MEDICAL INSTITUTE
General Studies -
Widefield High School
Bachelor of Science - Health Information Technology
University of Arizona Global Campus
Certificate - Creative Writing
Full Sail University
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