Customer Service Agent

TJ Ross

Bedford, TX

Cell: 682-***-****

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I possess significant experience in various facets of business to propel my team and ultimately my company to the next level. A strong desire to help others learn and grow within the industry drives me to provide the highest quality of service to both internal and external stakeholders. Summary of Qualifications:

● Licensed Life and Health Insurance Agent in all 50 states and DC

● Specializing in recruiting, employee retention, compensation, and managing employer group benefits

● Processed health and welfare benefit open enrollment events

● Identified opportunities to improve business processes

● Strong analytical and technical problem solving skills

● Proven track record in managing project schedules, resolving conflicts, supervising, training, and mentoring

● Proficient in Word, Excel, PowerPoint and SharePoint applications

● Effective listening and reading comprehension skills EMPLOYMENT:

Independent Licensed Life and Health Insurance Agent 8/01/2021 – Present date

Selling life, health, and supplemental insurance products to prospects across the nation. Mercer (Marsh and McLennan Companies)

HR and Benefits Analyst

08/06/2018 – 7/31/2021

Handled full recruiting efforts for mid to executive level candidates. Conducted hiring, training, employee retention, compensation, and benefits enrollment projects. Interfaced with hiring managers to attract elite candidates for exempt and non-exempt level positions. Answered, documented, researched, and monitored employee calls, emails/transactions for case resolution. Recorded client issues and escalated to the appropriate support team to be addressed. Leave of absence, Short Term Disability, FMLA, and Paid Family leave subject matter expert. Processed status changes related to COBRA updates. Assisted pre and post 65 callers with enrollment process and questions to achieve sales targets. Responds to both standard and more difficult customer inquiries regarding products. Explains all aspects of benefits offerings including processing qualifying life events, dependent verifications, and submitting appeals/exception requests. Researches to respond to customer inquiries, and responds formally to correspondence, either verbally or in writing, utilizing all reference material necessary to provide an informed response to the customer. Requests additional/missing information from the customer via letter or telephone call to answer customer inquiries. Provides written and verbal feedback to external stakeholders, colleagues, and management in a professional manner. Assists with New Hire benefit elections and Annual Open Enrollment events. Completes carrier benefit audits and correcting benefit statements. OptumHealth 09/29/2014 – 09/01/2015

Medicaid Client Advocate

● Obtained Texas Life and Health Insurance License ● Provided objective information regarding how to obtain Medicaid coverage. ● Answered inquiries from prospective and existing members related to the Medicaid enrollment process, eligibility status/issues, and benefit levels. American Cybersystems (ACS) 04/2012- 04/2014

Talent Acquisition/ HR Coordinator

● Answered complex benefits and HR policy and procedure questions. ● Processed Unemployment Claim disputes from inception to completion. ● Strong understanding of short term and state disability procedures. ● Initiated Leave of Absence (FMLA) requests. ● Processed transactions by collecting required information or backup documentation. ● Collaborated with Leads, Managers, Payroll, and HR Business Partners to resolve escalated issues. ● Answered incoming requests via telephone, internet, and/or correspondence from associates. ● Resolved customer requests/issues by researching and taking additional steps as required.

Fast Debt Solutions 01/2005 - 2/2012

HR Manager

● Coordinated benefits enrollment. ● Processed payroll reports via SAP/CATS. ● Responded to unemployment claim inquiries. ● Documented settlements and cases in Salesforce. ● Initiated FMLA/Short Term and State disability claims. ● Gathered employee census data for electronic submission. ● Prepared on-boarding materials and set up benefits for new hires. ● Assisted with timecard and accrued time off inquiries and adjustments. ● Processed payroll and assisted with timecard and paycheck corrections. ● Assisted with Talent Acquisition process and Performance Reviews via Taleo. ● Supported a portfolio of 400+ clients assisting with concerns related to their debt. ● Reset passwords for clients’ GCS account and assisted with helpdesk troubleshooting. ● Sales- pitched potential clients on the benefits of the program and enrolled new accounts. ● Negotiated settlements and setup lump sum settlements using the clients’ GCS savings account. ● Established a team of associates and oversaw various HR projects from inception to completion ● Reviewed accounts weekly to ensure that representatives contacted clients with past due balances ● Coordinated annual and ongoing eligibility/enrollment for client’s health and welfare benefit programs

Caremark Richardson TX 3/2002-1/2005

Senior Resolution Specialist (Team Lead)

● Claims processing and billing. ● Password resets and troubleshooting. ● Performed user acceptance testing and ran SQL queries. ● Supported escalated accounts as a form of service recovery. ● Identified and documented defects and using defect-tracking systems. ● Provided customers with physician referral & credentialing information. ● Mentored new advisors with immediate translation of benefit parameters. ● Created a quick reference guide to assist new hires and seasoned advisors. ● Forwarded complex benefit inquiries to internal support teams for correction. ● Processed claims and transactions using AS400, Siebel (Stars), and PeopleSoft systems.

Education:

Franklin D Roosevelt Diploma- May 1994

Texas Woman’s University Dental Hygiene 1998

ITT Technical Institute Information Systems Administration 2016 License:

Texas Life and Health Agent # 2001592 (licensed in all 50 states and DC) 2023-24 AHIP Certification (Medicare)

Key Skills:

PeopleSoft, Workday, Taleo, Various ATS Software Application, SalesForce, CATS, SAP, FMLA Benefit Tracker, AS400, Microsoft Office Suite, ADP, Exponent, Benefitsolver, UltiPro, NICE, ROD, Empyrean, and SLP

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