Customer Service Representative

Jennifer Frazier

**** *. ******* ***** *** **** Irving, TX 75061 · 817-***-****

*****************@*****.***

A polite, enthusiastic, and compassionate Senior Customer Service Representative with over ten years of experience in providing exemplary customer support in a busy environment. With the ability to consistently deliver a high level of performance in any job role as well as the ability to understand a customer's needs and wants and start directly to create satisfactory solutions. SKILLS

Excellent verbal and written communication skills

CMS Regulatory & Compliance Knowledge

Case Resolution/ Problem solving

5+years, AS400, IEX, CTI, Maestro, Facets, DMEVS, Qualtrics, Qfinity

Knowledge of Medical & Prescription Claims

Proficiency with Windows PC applications and Microsoft Office Suite

Grievance Handling

Ability to keep all company sensitive documents secure while maintaining excellent organization of files

Experience in Medicare & Medicaid benefit rules and regulation

10+ years of experience in a call center setting and phone support role

Ability to keep all company sensitive documents secure while maintaining excellent organization of files

PROFESSIONAL EXPERIENCE

July 2018 – Present

UnitedHealth Group - M&R Complex Care SR. DSNP Navigator

• Exceeds the performance goals established for the position in the areas of efficiency, call quality, provider satisfaction, first call resolution and attendance

• Ask appropriate questions and listens actively to identify specific questions or issues while documenting required information in computer systems

• Contact care providers (doctor's offices) on behalf of the customer to assist with appointment scheduling or connections with internal specialists for assistance when needed

• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues

• Provide education and status on previously submitted pre-authorizations or pre- determination requests

• Handle escalated calls, resolving more complex customer issues in a one and done manner

• Provide education and status on previously submitted pre-authorizations or pre- determination requests

October 2014 - September 2017

Bank of New York Mellon Client Escalations Support Liaison

• Resolved an average of 150 inquiries in any given week via email and phone for assigned clients and consistently exceeded performance benchmarks in all areas (speed, accuracy, attendance, documentation, and call volume).

• Ask appropriate questions and listen actively to identify specific questions or issues while documenting required information in computer systems

• Maintained and exceeded all goals and standards set by management. Using analytical ability, using an assertive approach, and overcoming customer objections.

• Research complex issues across multiple databases and work with support resources to resolve customer issues and/or partner with others to resolve escalated issues

• Provide education and status on previously submitted pre-authorizations or pre- determination requests

• Ability to multi-task duties as well as the ability to understand multiple products and multiple levels of benefits within each product

EDUCATION

Chaparral High School High School diploma

UHG Employee Experience Champion

UHG Member Experience Champion 2023

UHG Net Promoter Score certification 2023

UHG Medicare & Retirement Certified in 1 and 2

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