Yolisma Parras
@yolismaparras
Claims and operations professional at MAXIMUS who analyzed performance data and improved claims and appeals workflows.
United StatesWhat I'm looking for
At MAXIMUS, I reviewed call quality and performance metrics, then created and analyzed Excel and Power BI reports to support operational reviews.
I evaluated dashboards and pilot data, documented observations, and recommended process improvements. I also reviewed escalations and reassigned cases when appropriate.
As a Supervisor at MAXIMUS, I supported team members handling health insurance claims filing and appeals, and reinforced accurate documentation and established procedures.
Earlier, I assisted customers with health insurance claims and billing questions across Medicare and the Health Insurance Marketplace. I’m fluent in English and Spanish and am seeking a remote role in claims, billing, quality assurance, reporting, or operations support.
Experience
Work history, roles, and key accomplishments
Monitored call quality and reviewed performance metrics to identify trends and improve accuracy. Created and analyzed reports using Excel, Power BI, and internal systems, and supported process improvements.
Reviewed employee performance and call quality, provided coaching, and supervised teams handling health insurance claims and appeals. Trained new employees on policies and procedures.
Assisted health insurance customers with claims and billing questions, researched issues, and explained filing and appeal steps. Documented interactions accurately and met service benchmarks.
Assisted Ambetter health insurance customers with billing questions, payment processing, and payment arrangements. Resolved service concerns and provided floor support.
Customer Service
Zamorano Professionals Notary
Aug 2016 - Jun 2017 (10 months)
Answered calls, scheduled appointments, welcomed customers, identified service needs, and entered orders into electronic systems.
Education
Degrees, certifications, and relevant coursework
Gladys Porter High School
High School Diploma, General Studies
Earned a High School Diploma from Gladys Porter High School in Brownsville, Texas.
Tech stack
Software and tools used professionally
Availability
Location
United StatesAuthorized to work in
Salary expectations
Job categories
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