Customer Service, appropriately greet and assist customer/pstirntd

Elizabeth Accolla

EXPERIENCE:

Visiting Nurse Service of New York Choice Health Plans June 2011 – January 2024

Senior Member Retention Representative March 2013 – January 2024

Managed a high volume of calls from VNSNY CHOICE plan enrollees, answered inquiries related to all VNSNY CHOICE products, and recorded resulting actions/comments.

Ensured potential members understood eligible plan details/options, providing customer satisfaction and minimization of member cancellation.

Communicated with providers regarding eligibility and authorizations.

Documented complaints by listening to members/member families and determining resolutions.

Maintained member and family confidence by keeping complaint information confidential.

Improved quality results by studying, evaluating, re-designing patient complaint processes and implementing changes.

Coordinated request for enrollment plan changes and kept sales management and staff appraised of activities concerning established and new members.

Followed up and resolved escalated inquiries from Manager, Supervisor or appropriate Community Liaison.

Performed all duties within CMS guidelines, followed rules/regulations and stayed up to date on all new marketing policies.

Conducted field seminars for potential members, participated in special projects and trained new employees.

Customer Service Representative June 2011 - March 2013

Acted as a Customer Care Center liaison to VNS staff, departments and programs.

Screened incoming telephone calls to determine customer needs and directed clinical situations to the appropriate clinical staff/program in a professional and timely manner.

Made outbound calls to member for problem resolution.

Aimed at improving quality, and regulatory compliance.

Responded to and resolved non-clinical problems, complaints and issues.

Maintained correspondences, coordinated mailings to clients and providers as needed.

Assisted with the planning/implementation of customer service, telephone responsiveness activities and projects.

Organized/maintained records of customer service logs, performance reports and other data as needed by

management.

Created/maintained training manuals and assisted in training temporary employees.

Visiting Nurse Service of New York Health Plans – Temporary Assignment May 2009 – June 2011 Call Center Customer Representative/Data Entry

Answered phones and responded to member requests.

Reserved transportation service for members to and from medical appointments.

Transferred member calls to appropriate medical staff.

Identified, researched, and resolved member issues using the computer system.

Followed-up on member inquires not immediately resolved.

Completed call logs/reports and reported results to supervisor on a weekly basis.

Responded to members inquiries with courtesy and patience.

Entered all information into a shared database.

EDUCATION

CUNY Borough of Manhattan Community College-earned credits towards degree

HS Diploma

SKILLS

Type 60 wpm, MS Word, MS Excel, MS PowerPoint, MLTC, Epaces, Marx, Facets, Salesforce, Fluent Spanish

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