Customer Service Management

Danet Neal

***** ***** *** * #****

Seattle, WA *8133

(206) 898- 1889

*******@*****.***

Objective: To obtain a position that will enable me to use my strong human

relations skills, management skills, negotiation skills, organizational

skills and continue to retain and grow the business.

Summary of Qualifications

. Extensive experience in Account Management, Project Management and

Sales, including health products and services for International and

Domestic Markets.

. Excellent oral and written communication skills which includes

interpersonal and negotiation skills.

. An Organized and detailed-oriented Sr. Account Service

Representative, able to prioritize and delegate task effectively to

ensure timely project completion under extreme stress and pressure.

. Multi-tasks to accomplish workload efficiently

. Excellent team player, equally efficient and has a strong sense of

self-motivation for executing tasks in an autonomous fashion.

. Excellent leadership skills in producing positive results, by

motivating my team members to "think outside the box" in order to

maintain, retain and grow the business.

Professional Experience

Sr. Account Service Representative, Aetna International. Seattle, WA

October 2007- November 2013

. Effectively manage a large Book of Business and supports the

development of strong relationships directly with customers and

internal business partners that lead to the achievement of

customer satisfaction, profitable growth and earnings targets.

. Acts as subject matter expert and key point of contact for

International Corporate accounts.

. Manages all plan administration activities, including

installation, plan set-up, eligibility, billing and drafting by

working proactively with support areas.

. Collaborates with my internal team to achieve growth/renewal

objectives; assists in preparation and delivery of renewal

packages.

. Serves as a facilitator to assure coordination and integration

of all work processes.

. Identifies areas for process improvement and assists in the

documentation of these items.

. Prepare and delivers customer and member presentations.

. Performs independent analysis and provides guidance on more

complex cases and planning resources and works with

customer/internal constituents, to identify issues and create

and execute action plans.

. Facilitates and participates on cross functional teams in

creating business solutions and accomplishing stated goals.

. Supports Compliance and collaborates to ensure implementation of

laws and regulations and monitoring for ongoing compliance;

actively participates in market conduct exams as needed;

escalates impediments to compliance and works collaboratively to

resolve.

. Partner with our marketing area to develop international

marketing materials and resources for our internal and external

constituents.

. Coordinate and lead customer meetings to articulates Aetna's

products and services effectively contrasts the benefits of

Aetna's products/services with those of the competition

. Responsible for communicating Aetna International's policy

changes and creating communication pieces to distribute to

Aetna's internal and external constituents.

. Strategically identify new products and services that will

benefit my customers and coordinate a train the trainer session.

. Coordinate and lead training sessions for my peers to better

understand Aetna International's policies, workflows, products

and internal systems.

Customer Service Consultant, Aetna, Inc., Seattle, WA August 1999 -

October 2007

. Handled customer service inquiries and problems via telephone,

internet or written correspondence.

. Act as a subject matter expert by providing training,

coaching, or responding to complex issues.

. Identifies and analyzes the upstream and downstream

contributors to resolve service and contract conflicts

. Performs research and analysis of multiple data sources in

order to auto adjudicate medical and dental claims.

. Navigates systems efficiently in all constituent interactions

. Effectively utilizes advanced functionality of Aetna's

standard office technology tools and shares expertise with

others

. Responds to requests received from Aetna's Law Document Center

regarding litigation; lawsuits.

. Explain member's rights and responsibilities in accordance

with their contract

. Experience in medical and dental terminology

. Auto Adjudicate medical and dental claims, which include

sending out letters, researching file documents, working with

various systems, mail management, and responding and managing

various mailboxes within the Group Insurance.

Youth Advocate, Central Youth and Family Services, Seattle, WA 1996-

1998

. Provided educational seminars, training sessions and family

support services to assist families in improving their

lifestyles.

Computer Skills

. Microsoft Word, MS Office, Excel, Access, PowerPoint,

SharePoint, Windows XP and Salesforce.com.

. Internal Aetna systems:

o Automatic Claim Adjudication System - Claims

o Aetna Administration System - Billing

o Member Enrollment Application - Eligibility

o Aetna Strategic Desktop - Customer Service

o Customer Coverage Inquiry - Benefits

o Enterprise Provider DB - Provider database

o Aetna Trak - Ordering communications/welcome kits

o Aetna International Desktop Resource

Education Trainings

. Bachelor's degree in Business, in progress

. Insurance License, Life and Disability, 2007

. CNA Certified Nursing Assistance, 1997

Contact this candidate