Roslyn Jeannette Morales Morales de Marroquin
Oncology Reimbursement Agent
Guatemala
Summary
Detail-oriented Reimbursement Specialist experienced in analyzing and negotiating insurance claims. Delivered effective customer service and coverage evaluations through strong communication and problem-solving skills. Focused on achieving timely resolutions to billing concerns while maintaining accurate recordkeeping.
Overview
20
20
years of professional experience
12
12
Certifications
2
2
Languages
Work History
Reimbursement Specialist
Teleperformance
05.2025 - Current
- Billed and collected for claims submitted on clients' behalf with sales totaling $[Number].
- Followed up on denied and unpaid claims to resolve problems and obtain payments.
- Followed up on denied and unpaid claims, resolving issues to secure outstanding payments.
- Delivered timely information to insurance representatives to resolve common and complex issues.
- Delivered timely information to insurance representatives, facilitating resolution of common and complex claims issues.
- Guided office staff on how to effectively complete prior authorization forms and appeals documentation to achieve positive results.
- Guided office staff in completing prior authorization forms and appeals documentation, leading to successful approvals.
- Maintained comprehensive knowledge of healthcare billing practices, staying current on industry updates and changes in regulations.
- Advanced internal communication channels by sharing best practices among colleagues, fostering an environment of continuous learning and improvement.
- Maintained patient confidentiality by adhering to strict HIPAA guidelines when handling sensitive information.
Prior Authorization Representative
Panamericancommunications
11.2020 - 04.2025
- Drafted and issued denial letters outlining reasons for denial and available appeal options to ensure clear communication with stakeholders.
- Developed and updated spreadsheets tracking medical procedures alongside insurance denials and approvals to support data-driven decision-making.
- Fielded telephone inquiries on authorization details from plan members and medical staff.
- Responded to telephone inquiries on authorization details from plan members and medical staff, providing accurate information to facilitate timely care.
- Participated in ongoing professional development opportunities to stay current on best practices within the field of prior authorization services.
- Contributed to a positive work environment by effectively communicating with team members and fostering collaboration.
Business Credit Servicess Agent
Telus International
03.2018 - 11.2020
- Outlined policies and procedures to clients, enhancing their understanding and compliance.
- De-escalated and resolved customer complaints, delivering timely and professional service to restore satisfaction.
- De-escalated and resolved customer complaints with punctual, polite and professional service.
- Guided clients through claims process, facilitating timely resolutions and favorable outcomes.
Senior Supervisor
Transactel, S.A. TELUS Account
01.2011 - 01.2014
Senior Quality Assurance
Transactel, S.A. TELUS Account
01.2010 - 01.2011
Quality Assurance
Transactel, S.A. TXU Account
01.2008 - 01.2009
Customer Service Representative
Transactel, S.A. TXU Account
01.2006 - 01.2007
Education
No Degree - Industrial Psychology
Universidad Mariano Gálvez De Guatemala
Guatemala City, Guatemala 05.2001 -
No Degree - Business Administration
Universidad Galileo De Guatemala
Guatemala City, Guatemala 05.2001 -
Carreer -
Colegio Comercial Guatemalteco CCG
Guatemala 05.2001 -
Biuligual Secretary -
Instituto Guatemalteco Americano IGA
Guatemala City, Guatemala 05.2001 -
No Degree - High School
Colegio Sistematizado En Computación
Guatemala City, Guatemala 05.2001 -
Secondary School -
Liceo Victoria Y Libertad
Guatemala City, Guatemala01-1999
Primary School -
Colegio Nuevo San José
Guatemala City, Guatemala01-1998
Skills
- Reimbursement policies
- ICD-10 CM coding
- Claims processing
Eligibility verification
Insurance verification
Medicaid
Medicare
Payment processing
Healthcare software
HIPAA compliance
Financial reporting
Medical coding
ICD-9 coding
Client service
Microsoft office
Internet and e-mail
Healthcare industry
Certification
Six sigma training yellow belt Degree/Transactel, S. A. (2008) and (2010)
Timeline
Reimbursement Specialist
Teleperformance
05.2025 - Current
Prior Authorization Representative
Panamericancommunications
11.2020 - 04.2025
Business Credit Servicess Agent
Telus International
03.2018 - 11.2020
Senior Supervisor
Transactel, S.A. TELUS Account
01.2011 - 01.2014
Senior Quality Assurance
Transactel, S.A. TELUS Account
01.2010 - 01.2011
Quality Assurance
Transactel, S.A. TXU Account
01.2008 - 01.2009
Customer Service Representative
Transactel, S.A. TXU Account
01.2006 - 01.2007
No Degree - Industrial Psychology
Universidad Mariano Gálvez De Guatemala
05.2001 -
No Degree - Business Administration
Universidad Galileo De Guatemala
05.2001 -
Carreer -
Colegio Comercial Guatemalteco CCG
05.2001 -
Biuligual Secretary -
Instituto Guatemalteco Americano IGA
05.2001 -
No Degree - High School
Colegio Sistematizado En Computación
05.2001 -
Secondary School -
Liceo Victoria Y Libertad
Primary School -
Colegio Nuevo San José
PERSONAL CREDITS
- Always being proactive and showing persistence in all of my life objectives.
- Responsible, respectful, punctual, English As Second Language
- Able to work under pressure
OTHERS
- CPE (Phone Lab) TXU Account
- Project named as: “Building Heroes” (Agents Performance) TXU Account
- Promoted to Lead Escalation Team QA TXU Account
- Ramp up project on mounting a QA Department & opening a new account in Quetzaltenango Guatemala TXU Account
- Training in Canada for setting up a new TELUS Account
- Worked at PGU (Post Graduated Unit) TELUS CAM MOBILITY
- Worked at PGU (Post Graduated Unit) TELUS CAM KOODO
- Worked at PGU (Post Graduated Unit) TELUS CAM FFH
PERSONAL INFORMATION
- Status: Married
- Nationality: Guatemalan
- Born in: Guatemala City
- Birth date: May 7th 1984
- Identification ID: A-1 1134882