Service Representative Advocate

Carry Marti

**** ***** **** *** **** Bay FL ***** Home 321-***-****

*****.*******@*****.*** mailto:********************@*******.***

OBJECTIVE:

Looking for a position where I can further develop my skills and be fully utilized for future growth

SUMMARY OF QUALIFICATIONS:

Twenty six years’ experience in the customer service

Supervisory/managerial experience; telephone monitoring skills.

Detail-oriented, self-motivated; able to set effective priorities and implement decisions to achieve immediate and long term goals, and meet operational deadlines.

Fluent in written and oral English

PROFESSIONAL BACKGROUND:

11/11/2018 to Current Health Advocate

Teletech-Orlando, Fl (Client – United Healthcare Medicaid & Medicare)

Duties:

Inbound health advocate for patience under United Healthcare Medicaid & Medicare

Educate on benefits, copays, deductibles, coinsurance and maximum out of pocket.

Review claims and educate on accums, escalate to processing team when errors are found in claims system.

Verify eligibility, run pharmacy test claims to see if prior authorizations are needed.

Contact Health care providers to make appointments on behalf of patient.

09/23/2019 to 03/01/2020

AssistRX - Orlando, Fl

Duties:

Conduct benefits investigations, provide support for prior auth. for assigned case

Verify specific patient benefits and document specifics including coverage, cost share and access.

Document and initiate prior auth. Identify any coverage restrictions, assist to expedite patient access

Communicate the results of the investigation.

2/2016 to 4/27/2018 Pharmacy Service Representative

CVS Healthcare –Orlando, Fl.

Duties:

Responsible for taking inbound calls from and placing outbound calls to patients, physicians and/or payers to obtain refill orders.

Update changes of benefits or insurance for billing purpose.

Building close relationships with patients to ensure their needs are taken care of and taking care of RX needs.

Triaging calls to other department in order to further assist patients.

2014 to 2015 Customer Service Advocate

Teletech-Melbourne, Fl (Client - Blue Cross Blue Shield)

Duties:

Assist members with their medical policy issues, cancel or reinstate policies as needed.

Take payments and register members on direct auto draft. Educate on benefits, copays, deductibles, coinsurance and maximum out of pocket.

Review claims and educate on accums, escalate to processing team when errors are found in claims system.

Educate on Affordable Care Act guidelines and work with the Gov. Market Place for policies that have been initiated from the Exchange.

Explain EOB’s as well as plan Summary of Benefits to members and educated on how medical plan works.

06/2012 to 07/2014 Customer Service Representative

Percepta-Melbourne, Fl (Client – Ford Motor Company)

Duties:

Handled incoming calls and assister customer issues with their Ford, Mercury, Lincoln vehicles.

Helped customer’s locate dealers to repair recalls and engine concerns.

Worked with dealers to ensure vehicles were being repaired under warranty and following Ford repair guidelines

Escalated customer issues to tier 2 in order to further assist customer with new vehicles whom experienced ongoing multiple repair concerns.

Worked with all levels of the company to ensure customer’s concerns were being handled properly and we expedited repairs as needed.

For travelling customers with broken down vehicles, assisted in towing vehicle to nearest dealer as well as offered rental vehicle while customers’ vehicle was being repaired.

Utilized multiple Ford Motor Company resources in order to resolve customers concerns

11/1997 –10/2011 Trainer, Team Lead and Quality Assurance Advisor, Customer Service Rep

Comcast, Denver, CO

Duties:

Trained and developed all new incoming agents, as well as facilitated continued training.

Responsible for handling inbound team and delivering stats, facilitate performance appraisals, and d service level metrics were achieved.

Monitored agents calls, provided feedback to agents as needed and provided guideline to agents to further coach and develop their skills.

EDUCATION BACKGROUND:

1989 High School Diploma

Lakewood – Colorado

References furnished promptly upon request

Contact this candidate