Customer Service Health

Carlos A. Lujan

**-** **** ****** - ********, New York 11372 - Tel. 347-***-****

OBJECTIVE: Seeking a position that will utilize and develop my client

relations/ customer service skills with room for growth and

advancement.

PROFILE: Exceptional communication, interpersonal, and organizational

skills.

Ability to direct complex projects from concept to fully

operational status.

Goal-oriented individual with strong leadership capabilities.

Organized, highly motivated, and detail oriented problem

solver.

HIPAA Certified

EMPLOYMENT HISTORY

04/2010-08/2010 BrightStar Care, New York

Staffing Services Manager

. Managing ongoing client staffing process, including:

scheduling staff for both new and existing client

engagements.

. Support of hiring process, including gathering required

background information and paperwork

. Monitoring customer compliance process to ensure any new

employees placed at a customer are 100% compliant within 1

days of placement

. Weekly time sheet review and billing, and payroll processing

. Gathering feedback on employee performance to ensure customer

satisfaction

. Maintaining licensing database to ensure that all active

employee certifications are in compliance with state and

federal requirements.

04/2006- 12/2009 Building Service 32BJ Benefit Fund, New York

Member Service Representative I

. Display proficiency in all processing systems: eligibility

process, Empire BCBS benefits and system, COOL system.

. Collecting and analyzing data/information to resolve a

problem in real time, at high volume standards to provide

customer service and education to participants in regard to

Fund benefits and eligibility issues.

. Assisted members better understand Pension, Short/Long Term

Disability, Medical, Vision, and Dental Benefits. Walked

members through policies and procedures of all Fund Benefits.

. Handling of inquiries through vendors, Optical, Pharmacy, and

Employee Assistance

. Work within Call Center; handled between 50-80 inbound and

outbound calls on a daily basis, also within Walk-In-Center

to assist members on a face-to-face basis.

04/2004- 04/2006 Maximus Inc. (New York Medicaid Choice)

Enrollment Counselor

. Responded to enrollment service calls within Call Center,

provided request via TTY/DD line, mailed via Maxstar,

information inquiries in response to requests.

. Assessed client's health care needs and assisted clients in

choosing a health program.

. Assisted clients in enrolling and dis-enrolling, as well as

transferring from health plans, also provided eligibility

benefits for Child and Family Health Plus recipients.

. Documented and referred reported complaints for handling by

appropriate DOH, Health Plan and staff

06/2003- 03/2004 Health First - Medical Health Plan, New York

Member Outreach Representative (Temp.)

. Acted as a liaison between departments to research and

resolve member inquiries

. Contacted members to request additional information required

to complete the re-certification process

EDUCATION

ASA College of N.Y., New York

Expected Graduation 2011

Pursuing A.A. in Health Information Technology

SKILLS

. Fluent in English and Spanish

. Computer skills Windows 2007, Microsoft Word, Excel, Power

Point, Outlook

. Type 55 words per minute

Contact this candidate