Adrian Pino Email & Phone Number

Florida, United States

Miami, Florida, United States

• Operational Alignment: Developed and enforced practices and procedures to ensure alignment with the organization's mission, vision, and values, fostering consistency and focus across teams.
• Leadership and Task Prioritization: Led daily task prioritization, ensuring clear expectations and results among team members, promoting productivity and adherence to standards.
• Process Improvement and Compliance: Managed deviations from established practices, driving continuous… Show more
• Process Improvement and Compliance: Managed deviations from established practices, driving continuous improvement and ensuring compliance with organizational guidelines.
• Data-Driven Decision-Making: Leveraged analytical skills to perform complex duties, coordinate processes, and support strategic decision-making.
• Call Center Leadership: Managed inbound inquiries for the senior pod, resolving complex issues and ensuring accurate, timely solutions.

Miami, Florida, United States

• Quality Assurance Auditing: Identified and addressed quality issues in inbound/outbound calls and written inquiries by monitoring performance, analyzing data, and conducting thorough audits.
• Process Evaluation and Improvement: Conducted detailed research and analysis to identify root causes of defects and trends, providing actionable insights to improve quality and efficiency.
• Reporting and Recommendations: Developed and presented reports on audit findings, including… Show more
• Reporting and Recommendations: Developed and presented reports on audit findings, including recommendations for improvements, and training opportunities, ensuring management had clear visibility into quality issues.
• Compliance and Fraud Investigation: Ensured compliance by reviewing guidelines, investigating potential non-compliance or fraudulent claims, and forwarding findings for further action.
• Performance Documentation: Monitored and evaluated call quality, documenting issues and performance metrics for management review and continuous improvement. Show less

Miami, Florida, United States

• Customer Support and Education: Consulted with customer service to address complex insurance claims and policy questions, resolved issues, and ensured clear understanding of products and services.
• Policy Interpretation: Performed in-depth research to respond to inquiries, interpreting policy provisions to provide effective solutions.
• Claims Adjudication: Reviewed and adjudicated high-risk claims, ensuring accurate processing according to contract benefits and organizational… Show more
• Claims Adjudication: Reviewed and adjudicated high-risk claims, ensuring accurate processing according to contract benefits and organizational guidelines.
• Claims Processing: held claims, processed adjustments by collaborating with ambulance services, inpatient facilities, and other stakeholders.
• Research and Development: Conducted detailed research to develop claims, including contacting providers or members for additional information.

Doral, Florida, United States

• Call Management: Promptly answered incoming calls, screened inquiries, and relayed messages efficiently, ensuring seamless communication.
• Patient & Referral Relations: Warmly greeted patients, referral sources, and healthcare professionals, creating a welcoming environment and fostering positive relationships with business partners like insurance.
• Patient Intake & Authorization: Managed patient intake processes by verifying… Show more
• Patient Intake & Authorization: Managed patient intake processes by verifying benefits, co-payments, visit limitations, and authorizations to ensure seamless patient experiences.
• Scheduling & Record Management: Efficiently scheduled patient appointments according to clinic policies and maintained accurate patient records in compliance with organizational guidelines.
• Insurance & Payment Processing: Completed insurance verifications, collected co-payments and deductibles, and ensured proper billing practices.

Miami, Florida

Miami, Florida

Customer Issue Resolution: Addressed customer inquiries, complaints, and billing issues with the utmost courtesy and professionalism, ensuring one-call resolution and providing alternative solutions to retain customer business.Account Activation & Billing: Handled business transactions related to new customer account activations, processed billing.

Miami, Florida

Bachelor Of Arts - Ba, Health/Health Care Administration/Management, 3.85 Gpa

Associate Of Arts (A.A.), Business, Management, Marketing, And Related Support Services