Customer Service Social Media

Johnny C. Hines Jr.

***** ******** ** *** **** Richey, Fl. 34654

Cell: 863-***-****

PROFILE

Dependable, resourceful individual with progressive and diversified experience in Collection Customer Account Relations Management. Proven team player able to work independently through own initiative. Exceptional Team Leadership communication/interpersonal and organizational skills. Outstanding customer resolution and problem-solving skills. ACCOMPLISHMENTS/ACHIEVEMENTS

Certificate of Completion Account Services - Atlas Training 2000 Certificate of Completion (A. C. A. INTERNATIONAL) - Collections Certification 2000 PREP Seminar Completed Qualified for: Team Leader/ S.M.E./ Assistant Supervisor & Quality Assurance Monitoring 2001 2018

Certificate of Completion Department of Financial Services Life & Health 2018 Microsoft Word, Excel, Outlook

PROFESSIONAL EXPERIENCE/QUALIFICATIONS

Experienced in Staffing / Recruiting /Team Leadership / Quality Assurance/ S.M.E./ New Hire Advisor Assistant Supervisor/ Re-engaging Candidates for employment / Business Development 8 years of customer service as a Single Point of Contact Account Relationship Management Assisting homeowners with loan modification applications. (Foreclosure Avoidance) Well established, developed Insurance professional who focused on both Commercial and Personal lines of Property and Casualty (Business, Auto, Property and Worker’s Comp). Comfortable and experience interacting with Business clients and managing the book of business. Offers extensive knowledge in Multiple Lines of Insurance Products such as Business Insurance and Personal Insurance Products. Skilled at marketing products and services to both Commercial and Personal lines of Property and Casualty (Proving presentations to customers and prospects). Enjoys collaborating with clients, insurance company associates, and her office colleagues. Demonstrates strong negotiation skills, is a result driven problem solver and natural business professional. Knowledge of workflows, binds and issues policies, certificates of insurance, endorsements, audits, rating, remarketing, certificates, reports and documents, renewals, cancellations, claims, billing etc. Experience administers appropriate technical documents to assure accuracy and completeness. Able in developing and implementing claims handling instructions and loss control programs. Able to implement and administer research-based customer service plans and provide risk financing plan recommendations, including outlining specifications to market coverage and pricing to carriers.

Experience at responding to inquiries/requests for information as well as invoicing. Polished Interpersonal skills with professional phone skill sets. Targeted strengths include: Interpersonal Skills, Communication Skills (oral and written), Organizational Skills and Sales Skills. Exceptional attention to detail. Ability to self-motivate as well as motivate a team. New Hire Advisor, Head Administrator of Aerospace Community COGNIZANT: TAMPA, FL. 5/2016—--Present

COGNIZANT HCSC EGWP BCBS GROUP PLANS (EMPLOYER PLANS) Medicare Advantage Plans Insurance Medicare Advantage Plans

(Parts A, B, C&D) / Responds to telephone and web inquiries from members for healthcare benefits & eligibility Member & Physicians inquiries for healthcare benefits & eligibility. (Coverage, Cost Sharing,) Prior Authorization, Pre-Certifications, Prescription Coverage/Claims Support including Claims Audit / Outreach communications / Reviews and Issues/Research approvals for non-formulary requests based on Pharmacy and Therapeutics. Committee and CMS approved criteria for healthcare professionals via the prior authorization system. Explaining Pharmacy rejections codes and overrides. COGNIZANT / TMG Project – ClearStone (BCBS Medicare Blue Rx/ Medicare Blue Rx AZ/ Vibrant Rx

Senior Process Executive Specialist/ New Hire Advisor Medicare (Parts D) ONLY / Responds to telephone and web inquiries from members for healthcare benefits & eligibility Member & Physicians inquiries for healthcare benefits & eligibility. (Coverage, Cost Sharing,) Prior Authorization, Pre-Certifications, Prescription Coverage/Claims Support including Claims Audit / Outreach communications / Reviews and Issues/Research approvals for non-formulary requests based on Pharmacy and Therapeutics.

Committee and CMS approved criteria for healthcare professionals via the prior authorization system. Explaining Pharmacy rejections codes and overrides. COGNIZANT Project— MDX/ Agilon, Beacon LBS

(Senior Process Executive Specialist/ Prior Authorizations Processor/ New Hire Advisor) Process request for Molecular Genetic Lab Testing for various states for Medicaid Patients New Hire Advisor, Head Administrator of Aerospace Community COGNIZANT Project--(Social Media Content Moderator Analyst) Become and remain knowledgeable about Leading social media products and community. standards. Assist our community and help resolve inquiries empathetically, accurately and on time. Make well balanced decisions and personally driven to be an effective advocate for our community. Strong interpersonal skills, verbal and written communication skills and most importantly empathy. Display a strong bias to doing what’s right for our community in supporting leading social media objectives. Investigate and resolve issues that are reported on social media such as requests for account support and reports of potentially abusive content Respond to user inquiries with high quality, speed, empathy and accuracy. Use market specific knowledge, signals and insights to spot and scope scalable solutions to improve the support of our community of users. Gather, analyze and utilize relevant data to develop ways to improve the overall user experience on the site. Enforce social media terms of use by carefully monitoring reports of abuse on the site. Review the reported content within agreed turnaround times and standards of quality. Identify inefficiencies in workflows and suggest solutions. Recognize trends and patterns and escalate issues outside the company policy. COGNIZANT Project Bright Health Medicare Advantage Plans Insurance S.M.E.): Sr. Process Executive- Pharmacy Help Desk/ Pharmacy Services /Subject Matter Expert S.M.E. For Bright Health Medicare Advantage Plans Insurance Medicare Advantage Plans

(Parts A, B, C&D) / Responds to telephone and web inquiries from members for healthcare benefits & eligibility. COGNIZANT Project--(Emblem Health Insurance Pharmacy Helpdesk / Pharmacy Services) Member & Physicians inquiries for healthcare benefits & eligibility. (Coverage, Cost Sharing,) Prior Authorization, Pre-Certifications, Prescription Coverage/Claims Support including Claims Audit / Outreach communications / Reviews and Issues/Research approvals for non-formulary requests based on Pharmacy and Therapeutics. Committee and CMS approved criteria for healthcare professionals via the prior authorization system. Handled all escalated issues / potential denials to pharmacy case managers or medical directors for review. Prepares benefits approval letters /other duties projects as assigned. Answer pharmacy calls pertaining to Pharmacy rejections codes and overrides, aid to retail pharmacies ensuring issues are identified and resolved in a timely manner.

Determine whether system problems are software or hardware related and escalate to the appropriate department. Log calls into a proprietary call management system for tracking and reporting purposes. Serve as a liaison between pharmacies and insurance plan or claims processors to resolve prescription problems. Assist other departments with specific projects as assigned. Communicate to team and other departments of any pharmacy issues as they are reported. Cross train in other areas within the department. Handling:

• Grievance & Appeals

• Direct Member Reimbursement (D.M.R.) and MD Reimbursement

• Aids Drugs Assistance Program (ADAP)

Ultimate Medical Academy: (UMA) TAMPA, FL. 1/2016---4/2016 Alumni Career Specialist Advisor

Experienced in Staffing/Recruiting/Job Placement

Re-engaging Alumni Graduate Candidates for Employment/ Business Development Setting Scheduling Interviews for Experienced Graduates in Healthcare Field MAA/HS-MAA/MBC/MBCA/MOBS/HS-MOBS / Diplomas/Associates CONVERGYS: TAMPA, FL 10/2015 01/2016

Inbound Sales AT&T/ Receive calls from customers inquiry Billing, Product, account update upsell products Port line numbers/add new service. HSBC BRANDON, FL 11/2011 06/2015

ICC/ Customer Care/ Single Point of Contact MSS/Collection Rep 1I Servicing/Assisting customers with payment/billing information, Taxes/Insurance, (Escrow information) OCC / CFPB requirements /as a MSS Single Point of Contact (S. P. O. C.) Assisted homeowners with Loan Modification Application preparation. To help avoid foreclosure and to keep their homes if eligible & foreclosure alternatives. Submitted Request for Modification Affidavit to Underwriting for calculation. Informed customers regarding their account status. Liaison between customer and providing ensuring customer satisfaction. Maintained all activities on customer accounts. Resolution of customer account questions and problems. Provided customers with solution/workout options that can help with delinquent. accounts. Informed customers regarding their account status and payments options. Researched and resolved customer needs and inquiries. Discussing Exit Strategy inquiries. /Telephoned customers of past due accounts and resolved customer needs and inquiries. Provided customers with solution/workout options that can help with delinquent accounts. Informed customers regarding their account status and payments options. Ensured customer satisfaction to existing account holders. JP MORGAN CHASE HOME FINANCE, TAMPA, FL. 12/2007—10/2011 SPOC Agent/ Specialist / HL LM Accounts Relationship Manager 1 / H L Solicitor 1 Loss Mitigation Specialist 1 / Early Loss Mitigation / Collection Rep 2 /Risk & Compliance OCC / CFPB requirements as a Single Point of Contact (S. P. O. C.) Assisted homeowners with Loan Modification Application preparation. To help avoid foreclosure and to keep their homes if eligible & foreclosure alternatives. Submitted Request for Modification Affidavit to Underwriting for calculation. Inform customers regarding their account status.

Liaison between customer and providing ensuring customer satisfaction. Maintained all activities on customer account.

Resolution of customer account questions and problems. Provided customers with solution/workout options that can help with delinquent accounts. Informed customers regarding their account status and payments options. Researched and resolved customer needs and inquiries. Ensured customer satisfaction to existing account holders. Telephoned customers of past due accounts.

BRIGHT HOUSE NETWORKS, AUBURNDAL, FL. 08/2003 04/2007 Customer Service Representative TECH

Liaison between customer and cable providing ensuring customer satisfaction. Interact with Technical Support, Installer and Supervisor. Maintained all activities on customer account.

Resolution of customer account questions and problems. EDUCATION

MARIA REGINA DHS UNIONDALE, NY 1978 1982

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