Customer Service Representative

Helmon Gebremicheal

Columbus, OH *****

614-***-**** *********@*******.***

Professional Summary

Solution oriented, empathic team player and customer service expert with 13+ years of experience working in health services related call centers. Well regarded by managers, supervisors and colleagues for employing innovative and creative ideas to meet customer and business needs. Skills/ Abilities

• Ability to execute business plan

• Ability to research problems

• Excellent communication skills

• Interpersonal relationship expert

• Ability to retain business and client confidentiality

• Superior management skills

Professional Background and accomplishments

Aetna, New Albany OH 43054 2019-Present

Quality Assurance Specialist

• Monitor and evaluate quality

• Handle inbound and outbound calls

• Handle correspondence and documents quality and productivity issues and performance measures for management review

• Provide information to assist in the feedback and formal education process of call center staff

• Develop associates through coaching, sessions, provide guidance on the floor and assisting with the progress of associates individual training objectives Mac Advocate Center

Service Advocate

• Deliver a suite of service to members that support easy navigation of the healthcare system, from providing personalized next best action recommendations, to maintaining individual data accuracy and integrity

• Coordinate with clinicians to compile the member's Care Plan and conduct adherence follow-up

• Take ownerships and follow through on commitments

• Prioritize effectively to meet member service goals / deadlines

• Educate plan benefits, answers questions and resolve issues based on outreach campaign calls

Health Concierge

• Assist the member in finding their health ambition

• Use proactive, predictive and preventative analytics to service members

• Coordinate with clinicians to compile the member's Care Plan and conduct adherence follow-up

• Prioritize effectively to meet member service goals / deadlines

• Deliver a suite of services to members that support easy navigation of the healthcare system, from providing personalized next best action recommendations, to maintaining individual data accuracy and integrity

United Healthcare, Dublin OH 430**-****-****

Customer Service Supervisor

• Manage and direct the daily activities of the call center agents

• Develop team and individuals through monitoring and coaching associates

• Handle escalated customer services issues that cannot be resolved by Customer service agents in order to resolve issue and maintain positive customer relations

• Monitor random inbound calls to improve quality, minimizing errors and track operative performance

• Coach individual associates who may fail below desired performance using established company guidelines

• Review overall staff performance and recommend training needs Centene Corporation (Buckeye Health Plan), Columbus, OH 2016-2017 Sr. Customer Service Representative

• Provide assistance to member and providers regarding website registration and navigation

• Process forms require releasing pending claims to providers

• Work with other departments on cross functional tasks and projects

• Identify trends related to members and providers inquiries to respond proactivity and provide feedback to management

• Provide first call resolution, working with inter/external resources, completing necessary follow-up, and ensuring closure of the inquiry

• Maintain performance and quality standards based on established call center metrics including turn-around time.

• Assess and monitor inpatient census

Express Scripts, Inc. Dublin, OH 430**-****-****

Sr. Resolution Team Lead

• Demonstrate leadership qualities including organizations, multi-tasking and decision making skills

• Document detailed specifications and process

• Perform research by gathering and analyzing information, may require manipulating data and/or synthesizing from multiple sources

• Monitor call flow, volume, and real-time call metrics

• Contribute to “Voice of the Customer” providing customer insight to the organization

• Develop associates through coaching, sessions, provide guidance on the floor and assisting with the progress of associates individual training objectives

Contact this candidate