Customer Service Representative

CORA HAMLETT

**** ********* *****, ** *****, CA *2021 ● 619-***-**** ● ***********@*****.***

CAREER OBJECTIVE

Accomplished and versatile professional seeking an opportunity to leverage superior communication

talents, a strong work ethic and excellent organizational skills in supporting an organization to achieve

its established goals and objectives.

KEY QUALIFICATIONS

• Proven time management and multitasking abilities; skillfully balances competing priorities

• Displays a collaborative work ethic and a superior level of adaptability and initiative

• Outstanding combination of communication, interpersonal, organizational and

leadership skills

• Versatile and energetic; demonstrates high levels of personal commitment and dedication

• Self-directed and dependable; works autonomously without supervision

• Merges solid interpersonal and communication skills to develop strong customer relationships

• Blends integrity and innovative thinking to ensure first-rate customer satisfaction

• Displays strong decision-making talents, critical thinking skills, and an unwavering drive to excel

PROFESSIONAL EXPERIENCE

Customer Care Representative July 2013-January 2015

Sharp Health Plan – San Diego, CA

• Provide exceptional customer service, answering inbound calls and addressing member ques-

tions and concerns

• Conduct research and provide timely resolutions to customer issues

• Trusted with sensitive patient information, observing and remaining compliant with HIPPA laws

• Utilized effective and excellent communication skills with members and patients on a daily basis

• Work professionally, able to work efficiently with doctors offices, vendors, colleagues and other

operations team

• Complete outbound calls to new members, thoroughly explaining plan and benefits information

• Utilized the ability to accurately evaluate patient eligibility and benefits, policies and provide con-

tracted co-pay amounts

• Directly ensure that member records and contact information is current in IDX

• Initiate the process of doctor authorizations for select procedures

• Answer pharmacy customer service calls, updating member pharmacy benefits via MedImpact

accordingly

Senior Customer Service Representative February 2013-June 2013

Magellan Behavioral Health – San Diego, CA

• Directly contributed to organization performance by offering reliability, continuity and expertise in

all areas of the customer service function, leading to optimized levels of performance and cus-

tomer satisfaction

• Seamlessly handled a diverse workload with responsibility for confidential documentation, re-

search and analysis and information dissemination

• Provide assistance to members by aiding in their selection of a provider both in and out of their

contracted networks

• Conducted in-depth review of all documentation prior to filing, ensuring the highest standards of

accuracy

Customer Service Specialist August 2012-February 2013

Towers Watson - San Diego, CA

• Directly contributed to practice performance by offering reliability, continuity, and expertise in all

areas of the legal administrative function, leading to optimized levels of performance and client

satisfaction

• Thoroughly explain benefits to retirees of various industries and process qualified life changes

• Seamlessly handled a diverse workload with responsibility for confidential attorney support, doc-

umentation, research and analysis, information dissemination, filing, and client relations.

• Provided exemplary levels of confidential support, utilizing superior time management, organiza-

tional, and multitasking skills to handle competing priorities in a fast-paced environment.

• Provide the highest standards of professional and courteous service and support to clients from

diverse backgrounds and socio-economic conditions, enhancing the practice reputation external-

ly

• Utilized solid critical thinking skills to maintain accurate, up-to-date and confidential patient files,

carry out analysis of each file and make proper notations

Senior Customer Service Representative August 2010-March 2012

Opium Health - San Diego, CA

• Provide top notch customer service to providers and patients, supplying in-depth explanations to

all inquiries

• Employed demonstrated administrative skills to maintain up-to-date documentation and man-

aged an accurate filing system that improved information management and retrievability.

• Exercised outstanding interpersonal skills and analytical talents to provide timely and effective

resolutions to complex client concerns without loss of client goodwill or risk of further escalation.

Customer Service Associate November 2007-April 2009

Anthem Blue Cross California - San Diego, CA

• Directly responsible for the overall processing of all new groups and renewals with Anthem Blue

Cross

• Processed and ordered 1st impressions, accurate data entry in addition to daily faxing, copying

and scanning

• Provide thorough and accurate insurance information for all incoming and outbound calls, forging

strong customer relationships and customer loyalty with both clients and brokers

• Review and scrubbed all enrollment forms, preparing them for accuracy and smooth processing

•

EDUCATION

Foothills Adult School - GED

ADDITIONAL SKILLS

Computer Skills: Microsoft Office Suite (Word, Excel, PowerPoint, Publisher, Outlook Express); Adobe

Photoshop; Cactus, Sales Force, IDX (GE)

Technical Skills: 10 Keypad by Touch

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