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Customer Service Project

Anna, Texas, 75409, United States
January 01, 2018

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**** ******** ******

Anna, TX ***09

817-***-**** -C

Professional Accomplishments

Developed a training program for all new staff members on Noble’s ATOMSâ (Automated

Telephone Organization Management System)

Assisted with the transition of a call center to the automated system

Aided in the relocation of the call center with no downtime

Helped open new call center and trained all personnel in Euless, TX

Proficient on the Siebel System and CPR+ System

Professional Experience

AmeriSource Bergen/Lash Group November 6,2017 to Present(temp Position)

Under close supervision of the project Team Coordinators / Management team, the Benefits Verification Specialist will contact insurance companies, on behalf of the physician’s office, to verify patient specific benefits. The Benefits Verification Specialist will ask appropriate questions regarding patient’s benefits and complete data entry and/or appropriate forms to document patient’s benefits coverage.

Outbound Calls to Insurance Payors, will be scripted, following a Guide.

Collects and reviews all patient insurance information needed to complete the benefit verification process.

Verifies patient specific benefits and precisely documents specifics for various payer plans including patient coverage, cost share, and access/provider options according to Program Specific SOPs.

Verification process could include electronic validation of pharmacy coverage and medical eligibility.

Humana LifeSynch July 2015 to November 2016 Customer Service Rep(Temporary Position)

Receive, document and resolve member and provider inquiries by using established best practices Manage inbound and outbound contacts; including conducting a Health Risk Assessment to eligible members. Build lasting relationships with Humana’s members and providers Educate members, providers and employers about Humana’s products and services over the telephone and online (email) Answer phone calls utilizing a multi line telephone system Ensure accurate and timely processing of all requests by taking appropriate action, such as scheduling appointments, taking messages, transferring calls to appropriate staff Ensure thorough records are maintained by documenting discussion, messages and actions taken to process inquiries. Escalate customer complaints and/or calls to management as necessary Resolve patient issues through independent problem solving and with a goal of first call resolution Make outbound calls per assignment, special project or as needed Special projects as assigned, which may require time and work outside of answering or making phone calls, also taking claims calls.

Medco Health Solutions, Irving, TX July 2010 to December 2014

Customer Service Representative

Answers incoming calls from Medco members through the use of an automated dialer.

Appropriately identifies issues requiring escalation, referral to another functional area and/or submission for the grievance process.

Achieves specific call targets to include quality, average handle time and overall customer satisfaction.

Manages customer disputes and issues in a positive manner; conveys a positive image on the telephone.

Consistently achieves a positive member experience.

Participates in and successfully completes on-going training.

Participates and appropriately responds to test calls, client inquiries and/or testing exercises.

Adheres to department and company policies along with standard operating procedures.

Ensures audit, compliance and legislative requirements are adhered to and appropriate systems and controls are implemented as needed.

Performs other special projects, related duties and responsibilities as assigned. Determines the nature and resolution of member issues and questions, also taking claims calls.

First Service Networks Linthicum Heights, MD October 2004 to July 2009

Level II /Account Manager

Primary resource with customers and contractors for all orders and account inquiries

within their assigned region.

Interface with customer and/or account teams to gather necessary data to handle

customer requests and foster customer and contractor relationships.

Answer and explain questions/inquiries relating to products, services and features.

Contact and receive calls from various internal and external work groups to resolve

problems and/or obtain or furnish information.

Bay Area Research/Maryland Marketing Source Randallstown, MD

April 2003 to September 2004


Responsible for telephone interviewing of medical professionals, business professionals and

consumer on a myraid of research topics.

Conducts "Intercept" interviews, providing complete and thorough documentation of

respondents' answers.

Chesapeake Surveys (subsidiary of NFO Migliara/Kaplan) Owings Mills, MD

December 2002 to Janruary 2004 Project Coordinator

Team leader in a 40-station call center which specialized in medical and consumer market

research recruitment and customer service.

Coordination and management of multiple recruitment project teams to ensure all timelines and

specifications are met.

Prepared and conducted detail project briefings, training staff members on project specifications.

Daily contact with clients, providing written and verbal updates on projects.

Research Associate

Responsible for telephone recruiting of medical, business and consumer personnel.

Administered questionnaires by telephone and in-person to insure high quality interviews and


Maintained accurate quota management for all assigned studies.

Promoted to Project Coordinator.

Savitz Field and Focus Houston, TX March 2001 to December 2002

Recruiter, Interviewer & Focus Group Host

Responsible for telephone recruiting of medical, business and consumer personnel

Assisted in the hosting of focus groups and seeing to the comfort of the respondents.

Conducted “Intercept” interviews, providing complete and thorough documentation of the

respondents’ answers.

Hosted business professionals and consumer focus groups.

Heakin Research Houston, TX February 1997 to August 2001

Senior Recruiter, Lead Interviewer & Focus Group Host

Assisted manager with the day-to-day functions of the call center as well as project management

Responsible for telephone recruiting of medical, business and consumer personnel

Assisted in the hosting of focus groups and seeing to the comfort of the respondents.

Conducted “Intercept” interviews, providing complete and thorough documentation of the

respondents’ answers

Hosted business professionals and consumer focus groups.


1981 LaGuardia Community College Queens, NY

Introduction to Psychology

State certified GED Tutor

1973 Theodore Roosevelt High School

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