Customer Service Sales
Resume:
Tasha S. McCauley
*** ******* *****, ******** ******* PA, 19462
************@*****.***
Professional Summary: Insurance Customer Service Professional, HRA Account Representative, Good communication skills; written and verbal, Works in Office and Call Center environment, Healthcare Coordinator, Strong organizational, time management, and project management skills with multi-tasking abilities, Medicare certified Advocate, Sales Trainer,
COMPUTER SKILLS
Microsoft Word, Excel, Spectrum, ADP, Oracale, Citrix, PeopleSoft, Photoshop, Illustrator
PROFESSIONAL EXPERIENCE
Alorica San Antonio, TX 08/14- 08/16
PAYFLEX: HRA Account Representative 12/15- 08/16
Take inbound calls Assisting Insurance members, with Health Reimbursement Accounts.
Contact insurance providers and Employers via telephone, email, or correspondence on aged/delayed claims for resolution.
Professionally Communicates and provides explanations to all parties regarding the members health account (s) .
Work to resolve moderately to highly complex billing, claim processing, and reimbursement issues
Adhere confidentiality of all member accounts by following HIPAA guidelines
Ensure accuracy of billing, claims and timely payment to the members
Providing members of their account balance and transactions.
Researching accounts for reimbursements that have been issued out or missing.
Flexibility to assist with third party insurance follow-up based on need.
Effectively notate each call, document actions and results providing clear written communication, within organization policies and standards.
Sending out account balance and claim forms for reimbursements.
Report regularly to lead analyst or supervisor on payer trends identified
AETNA: Customer Service Healthcare Advocate 08/14-12-15
Handle inbound calls Assisting Aetna members, who are Medicare eligible, with their Insurance Health Plan.
Managing Inbound member calls and follow up with third parties, by phone or email
Assisting with medication and prescription questions on cost, coverage and available options.
Deescalating possible issues by addressing customer inquiries promptly, having the ability to come to a resolution.
Educate customers on products and services. Always highlighting the added value of the program so the customer will grow with the company in the future.
Determine the different needs of each member, using appropriate tools and support technology to assist.
Meeting sales metrics at a 97% Quality Assurance. Top personal stats qualifying for bonuses and top Group percentiles.
Sean John: Store Manager Elizabeth NJ/ Philadelphia, 11/07- 12/13
Meet and exceed store sales goals for each year
Recruit, Interview and hire a strong sales staff, ensuring all positions are filled in a timely manner with qualified personnel
Train and help develop sales staff
Schedule associates to maintain adequate floor coverage while maintaining payroll budgets
Process payroll weekly for all employees-(ADP, I-Employee)
Meet inventory accuracy and shrink requirements
Maintain a keen interest in the fashion industry and market trends
Develop sales techniques and assist in the development of associates’ sale techniques to maximize sales
DONNA KAREN NEW YORK King of Prussia, PA 10/ 05- 11/07
Charter Club Office Design Assistant
Exceed sales goals for the store
Build and maintain repeat clientele by utilizing personal client books
Support and encourage staff to provide great customer service i
FEDERATED MERCHANDISING GROUP New York, NY 09/02- 04/05
Charter Club Office Design Assistant,
Assisted Design Director on fashion direction, seasonal concepts and current trends, including
Conducted meetings with studios to select unique prints and embroideries for collections
MOORE COLLEGE OF ART AND DESIGN Philadelphia, PA 10/99- 06/02
Administrative Office Assistant
File and Organize student profiles.
Sent out follow up notifications and updates.
EDUCATION:
MOORE COLLLEGE OF ART & DESIGN (MCAD) Philadelphia, PA GRAD June 2001
BFA Fashion Design
3.7 GPA
5th Year Program Scholarship – 2002 Concentration in Textile Design
Dean’s List (1997 – 2001), Nathan Pincus Award, Polo Ralph Lauren Senior Accessory Award
COMMUNITY SERVICE/VOLUNTEER
Overbrook Park Church of Christ 03/09- 10/13
Office and Communication Committee
Young Adults Network in Christ
Page 2
Contact this candidate