MARLENY GARAY

**** ** *** ****** ***** Miami FL *3161

305-***-**** advp5i@r.postjobfree.com

Objective: To obtain a position which will enable me to utilize my training, skills and experience with opportunity for challenge and growth.

Languages ENGLISH – SPANISH

PROFILE: Experienced bilingual Customer Representative, adept at dealing with difficult issues and problems; dependable, responsible, organized and energetic, excellent interpersonal skills with the ability to relate to a diverse population: a team player; diplomatic and personable.

COMPUTER SKILLS: INTERNET MSWORD EXCEL POWERPOINT ACCESS OUTLOOK

EMPLOYMENT EXPERIENCE:

Aetna January 2022 to present

Outbound call agent for Medicare engagement specialist. Working with CEC, Med Compass and Lexis Nexis, Workforce and Teams. Send TPA forms, connect with case managers, warm transfer to customer service, use Teams to send dedicated cases.

Molina Healthcare

Member Services January 2020 to January 2022

Talks to customers over the phone, about their questions or concerns

Maintains and updates customer information as necessary

Calmly attempts to resolve and de-escalate any issues

Escalates calls to supervisor when necessary and appropriate

Responds to requests for assistance and/or possible processing of credit card authorizations

Tracks call-related information for auditing and reporting purposes

Helping member with grievances ; appeals ; PCP changes ; pharmacy; claims refunds and payments.

UNITED AUTOMOBILE INSURANCE COMPANY

UNDERWRITER CUSTOMER SERVICE 09/2018 to 12/2019

Acts as the first line of phone contact with the Company, answering 75 to 100 calls per day.

Attends to all questions and inquiries in a courteous and highly professional manner, providing exceptional customer service and developing a rapport with the caller.

Effectively services the business, including resolving agents' inquiries, complaints, and requests and acts as liaison with underwriting, billing, etc

Responds to inquiries by understanding the inquiry; reviewing previous inquiries and responses, gathering and researching information, assembling and forwarding information and verifying the caller’s understanding of the information and answers.

Records inquiries by documenting the inquiry and response in the policy accounts.

Prepares for inquiries by studying products, services, and customer service processes.

Enters and maintains policy requests received from agents and customers via telephone, fax or email.

Resolves inquiries quickly and effectively with strong customer service skills.

Reviews, analyzes and completes endorsement submissions according to established underwriting guidelines.

Handles cancellations/reinstatements and other miscellaneous policy changes.

Improves quality service by recommending process changes and identifying new product and service applications

All Safe Insurance 08/2015- 02/2018 Customer Service /Administrative Assistant

Answer all phone calls; take messages; document all calls; Request loss runs and attach in TAM; Check all polices sent to agent by e-mail; get endorsement send to customers. FAX-SCAN-COPY

PREFERRED MEDICAL PLAN 12/2013-08/2015 Customer Service

Assist with home health care and assist them with any procedures they are having in the hospital or out patient facility

Assist with authorizations, claims, referrals and pharmacy

Respond to member calls from members and providers and provide accurate service. Accurately document calls on QNXT

Attend meeting and training sessions as scheduled

Correct and process payment effectively

Make outbound calls to assist accounting

Verify all HIPPA calls

AAA EMERGENCY ROADSIDE SERVICE CUSTOMER ADVOCATE/DISPATCH 08/2006 -09/2013 Customer Advocate

Responsibilities include carefully monitor the progress of each request for road side service; ensuring Documenting every action taken on the service call; clear calls using accurate appropriate codes and charges; in troubleshooting delays; Using reference material needed to assist in providing service ; handling priority /red flag calls and police calls with a higher sense of urgency; Advised Supervisors/team leaders of any delay or other problems in rendering timely service; Keeps supervisors informed of problems; handling customer complaints; contacting law enforcement to members in unsafe situations; enrolling new members; calling law enforcement for babies locked in car

2013 BEST CO-WORKER OF THE YEAR AWARD

2009 RAVING FAN AWARD

EDUCATION MIAMI DADE COMMUNITY COLLEGE Associates in Arts

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