Membership & Enrollment Specialist, Customer Experience

Calli Churchill

# 712-***-**** *****-***@*******.***

Professional Experience

Wellmark Blue Cross and Blue Shield, Des Moines IA November 2022 – May 2023 Membership and Enrollment Specialist II (Operations) Self-direct health insurance policies for new or current members of multiple group market segments for Iowa and South Dakota regarding medical, dental, vision and hearing. Answer various queries from members, agents, sales, customer service, special investigations, billing, or privacy office.

· Achieve personal accountability with a proactive focus and skill to prioritize as well as sustain; adapt to everchanging occurrences

· Establish a prominent customer experience with agents and sales contacts of benefit coverages, policy revisions, HIPAA and group market guidelines or unnecessary repetitiveness

· Collaborate with colleagues to provide logical response on dire concerns of all group levels: Medicare Supplement, small group, large group, mid-size, individual under 65 and over 65

· Undergo urgencies for members in need of medical services or pharmaceuticals; typically, administering policies within CVS pharmacy client care access database

· Multitask distributing software applications: Microsoft outlook, Facets TriZetto, BlueSource, Citrix mainframe, CRM navigator, CVS pharmacy services, Workday, membership interface gizmo, Excel spreadsheets, document share drive, google chrome, and internet explorer Wellmark Blue Cross and Blue Shield, Des Moines IA May 2021 – November 2022 Customer Experience Advocate I (Operations)

Assist, research and educate through inbound calls from medical providers nationwide. Conduct meticulous notes and attachments as needed for each call case. Correspond with customer service seniors, claims, representatives, legal, and mail services.

· Maintain composure, professionalism, and patience with each caller

· Strive to achieve performance goals, quality, and daily metrics utilizing Power BI

· Frequently initiate feedback during outbound calls, occasional emails or web inquiries

· Communicate with inner departments relating to benefits, specific questions, updates or adjustments; result, call cases sent to the appropriate team for handling

· Advise or instruct ample information to clients utilizing distributed applications: frontier, claims inquiry screen, Microsoft outlook, Facets TriZetto, Citrix mainframe, CRM navigator, Workday, CVS pharmacy services, document share drive, google chrome, and internet explorer Wellmark Blue Cross and Blue Shield, Des Moines IA March 2014 – May 2021 Membership and Enrollment Specialist I (Operations) Self-manage health insurance policies of Iowa and South Dakota for Individual Medicare Supplements of age 65+ and large groups of 51+ employees. Review and respond timely to multiple inquiries or emails from members, brokers, groups, sales, customer service, legal, privacy office, and billing.

· Perform high quality and quantity; support coworkers with questions and production

· Create factual notes within membership systems to perceive details sufficiently

· Engage customer urgencies in need of medical services or pharmaceuticals; thus, implement policies within CVS pharmacy client care access database, often including COBRA

· Eagerly took lead role in organizing team outings, events, projects, contests, and overall team building within a yearly basis by budget expenses

· Balance between internal software applications: Microsoft outlook, Citrix mainframe, Facets TriZetto, CRM navigator, membership interface gizmo, legacy database, document share drive, health plan services, individual enrollment tracking, Excel spreadsheets, and google chrome DataVision (Palmer Group), Carlisle IA October 2012 - February 2013 Membership and Enrollment Specialist September 2013 - February 2014 Third party vendor for Wellmark Blue Cross and Blue Shield; processed health insurance applications and letters to update prior policies within individual membership or fax viewer.

· Clarified important details with applicants and agencies to finalize documents

· Logged each phone call of canon camera rewards to show growth status

· Processed camera model-lens numbers of warranty cards and sales receipts for rebates Equifax (Palmer Group), West Des Moines IA March 2013 - May 2013 Verification of Employment Specialist

Produced outbound calls to verify job status for home loans and re-financing for businesses across the United States.

· Exceeded the limit of twenty phone calls per hour

· Kept record of requested phone numbers for each borrower Education

Iowa Western Community College - Associate courses 2009-2010, Clarinda IA Clarinda High School - High School Diploma 2009, Clarinda IA Computer Experience

Microsoft Office: CRM Dynamics, Outlook, Word, Excel, Access, PowerPoint, OneNote, data entry Adobe: Acrobat, Photoshop, PDF

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