Customer Service Rep

Monique Alexander

Oklahoma City, OK 405-***-**** **********@*****.***

Objective

To obtain a challenging position which allows me to use my exceptional customer service skills while learning all aspects of the business.

Experience

Liberty Dental Plan / Customer Service Rep II 10/2021 - present

Answer all incoming calls from members, dental offices

Explain denied claim reasons, assist with emergency dental appointments

Document reason & resolution on every call

Educate member on IN/OUT of network capabilities

Midwest Flooring / Flooring Specialist 03/2021 – 09/2021

Verify all product was sold, shipped to members home for installment

Assist installers with any issues/request to complete job

Outbound calls to members to assure customer satisfaction

Follow through with customer and installers until job is completed

Interim HealthCare / Palliative Care Coordinator 01/2021– 03/2021

. Update Nurse Practitioners patient charts

. Update Excel spreadsheet to show cancelled, completed work

Enter payroll, scanning & faxing documents

Answer/direct calls to correct department

OptumRx / Lead Assist/Supervisor Escalations 10/2012-03/2020

. Educate reps on navigating multiple windows and apps to help resolve members’ request

. Process, expedite and track all Pharmacy orders.

Educate members on Pharmacy Benefits (Medicare, Medicaid, UHC, BCBS etc.)

Proactively request new prescription when use last refill

De-escalate all escalated calls.

Resolve all billing disputes, denied pharmacy claims, review benefit rules and apply overrides

when necessary to help claim to pay.

Education

S.N.V.T.C. (high school) / Las Vegas, NV graduated 87

Over 20 yrs Customer Service Experience

Skills & abilities

Great Time Management

Excellent problem-solving skills

Good written/oral communication

Flexibility with schedule

Over 20+ yr of Customer Service experience

Over 15yrs Call Center Experience

10+yr Medicare & Medicaid benefit experience

Contact this candidate