Customer Service Representative

Summary: I possess extensive experience in call centers providing the necessary customer service to members and consumers. I have worked from a representative assisting callers on a daily basis to a training specialist providing the needed leadership and management to maintain and meet all goals. I have also worked as a contract employee overseas in Iraq providing administrative, logistical and customer service skills working with the Armed Services. Ensuring that there needs is met on a daily basis. I have provided assistance and leadership to ensure that all is mission ready and capable.

Experience

08/2014 – 05/2015 Optum Healthcare c/o United Health Group

Senior Service Representative:

Assisted members and providers calling to inquire on behavioral health benefits. I provided the members with information on co-pays, deductibles and information pertaining to requests. I also, assisted providers with needed information on various benefits and options for members from quoting benefits and providing authorizations for various procedures.

Intake Coordinator:

Employed on a special project for the state of Ohio. I worked to complete authorizations for request for services from behavioral health clinicians for members. Obtained the needed information sent daily for completion and then input request for the times, dates and number of hours requested. Once completed compiled all information on a spreadsheet and sent to senior representatives.

Strategic Administrative Assistant:

Employed as a customer service representative working on a specific project for the state of Vermont; in assisting the Vermont Health Connect organization to clear a backlog of applications from 2013 and 2014 to be in compliance with the Affordable Health care act. My job duties and functions include:

Processing service request for applicants by inputting information from hand written applications.

Qualifying applicants for healthcare coverage for the state of Vermont based on their laws and regulations.

Notifications to consumers via telephone or letter of their results and to assist with decisions on coverage options.

Based upon customer needs, updating information of change of circumstance and change of information.

Processing renewals for healthcare coverage for applicants.

Customer Service Specialist: 09/2013 – 04/2014 General Dynamics Information Technology

Worked with CMS, the Center for Medicaid & Medicare Services which handles all 1-800-Medicare calls in the Contact Center Operations. Providing customer service to assist consumers in reference to the contract with 1-800-Medicare to support the Affordable Care Act and Health Insurance Exchanges.

•Provided consumers with needed information for obtaining insurance.

•Assisted with completing online applications for the Affordable Care Act.

•Completed the enrollment process for the consumers with various health insurance companies, explaining their benefits.

Record Retrieval Specialist: 04/2013 – 08/2013 Donovan and Watkins (MRC), Houston, Texas

Worked with Medical Research consultants as a Record Retrieval Specialist is responsible for the end-to-end process of collecting records and any other associated documents deemed necessary by our clients. Specialists work within an assigned caseload of subjects, and are responsible for obtaining the records within the service level agreement contractually agreed upon with the client. The Record Retrieval Specialist is the primary point of contact with the record custodian.

•Adhere to guidelines and procedures established by client SLA’s and project SOW’s in regards to record turnaround time

•Properly and timely process request orders from various sources including but not limited to: electronic direct orders, legal documents, e-mail orders, spreadsheet order forms.

•Conduct research via telephone, internet and other reference material to identify proper locations of custodians of records

•Confirm authorized letters of request have been received by custodians of records.

•Conduct follow-up calls with custodians to ensure requested records are collected in a time frame consistent with SLA parameters

•Follow-up with custodians on incomplete records, performing additional research if required

•Process invoices associated with obtaining records from custodians

•Conduct additional research from existing records to identify any additional record types and/or custodians to requires records from

Customer Service Representative: 05/2012 – 03/2013 Amerigroup Real Solutions, Houston, Texas

•Responded to inbound calls from various Medicaid members in 13 states in the USA.

•Assisted and researched information while assisting members in choosing a primary care physician or specialist for either themselves or family members.

•Provided the needed enrollment and benefit information to healthcare professionals for members.

•Obtained the needed information for authorizations needed for medical procedures.

•Updated or created new enrollment information for newborns to mothers enrolled with Amerigroup.

Benefits Specialist: 08/2011 – 04/2012 Spherion Staffing, LLC. (AON Hewitt) The Woodlands, Texas

•Working at assist various corporations with annual enrollment for insurance, thrift plan and other needed information for benefits and other area of interest to fulfill the questions for both new hire and tenured employees.

Administrative Specialist I: 07/2010 – 10/2010 Kellogg, Brown and Root, Inc. Tallil, Iraq

•Provided administrative and/or secretarial support to a department and/or Manager.

•Typical duties include general clerical, receptionist and project based work.

•Maintains daily reports; for accountability and statistics

•Structures the filing system to keep accurate records

Logistics Coordinator: 08/2008 – 07/2010 Kellogg Brown and Root, Inc. Baghdad, Iraq

•Assist clients including (Army, Air Force and Navy) personnel in building and preparing cargo on pallets.

•Prepare needed manifest for cargo to be transported by air transport either by fixed wing or helicopter.

•Maintains daily reports on the cargo shipped via KBR.

•Communicates with clients and management via logistical skills any needed information, objectives to ensure schedules are met.

• Assist with movement of passengers and cargo on and off flights in the helicopter and fixed wing terminal.

08/2008 – 07/2009 Kellogg Brown and Root, Inc. Baghdad, Iraq

•Maintains needs information for daily, weekly and monthly reports on maintenance, distribution and needed bacteriological test, transportation, maintenance and service issues

•Completes needed requests for parts and services

•Inventories and tracks all supplies, parts and materials

•Provides accurate information to manager and supervisors to assure that the client is knowledgeable of needed information.

•Coordinates information with customers to ensure desired logistics objectives, priorities and schedules are met and communicated to management.

•Analyzes work processes and develops metrics for measurement of performance.

•Troubleshoots problem areas in logistics and coordinates problem resolution or recommends solutions to management.

Customer Service Professional: 08/2007 – 08/2008 AIG Retirement Services, Inc. Houston, TX

•Assisted clients with information on their various retirement accounts.

•Completed transactions for clients for moving assets from one account to another.

•Provided information on gains and losses.

•Assisted brokers with setting up retirement accounts for clients

Technical Service Operations Supervisor: 08/2006 – 02/2007 EchoStar Communications /Dish Network, Alvin, TX

•Managed a team of 15 – 20 representatives daily

•Coordinated functions with management team to ensure the delivery of top quality and effective customer service.

•Ensured that the needs of the customers are identified and satisfied.

•Educated the agents on various policies and procedures.

•Motivated employees to achieve and surpass established expectations.

•Monitored lives calls, either side by side or via recorded calls to ensure quality technical and customer service expectations are being met.

•Led agents in up-training.

•Assisted with any and all non-routine agenda.

•Led meetings with agents on a daily basis to ensure communication of all updates and other needed information is provided.

Professional Training Specialist II: 1/2001 – 11/2005 First Data Corporation – TeleCheck, Houston, TX

•Delivered instructor lead training/learning sessions.

•Designed, developed, implemented and evaluated training documentation and aides.

•Partnered with various business units to close performance gaps.

•Supervised trainees, provided feedback and coaching to new hires.

•Proctored and calculated pre and post learning assessments.

•Assisted in the recruitment and interviewing process for potential employees.

•Implemented mini review sessions to build employee proficiency for their respective work areas.

•Worked with various managers and other support staff on special projects

Education: 2001 – 2003 Florida International University, Ft. Lauderdale, Florida

•ASTD Training and Development Certification

Skills and Proficiencies: Microsoft Word, Microsoft Excel, Power Point, People Soft, Kronos, CUBS, Dish-Smart, Cisco

References: Available Upon Request

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