Customer Service Member

Patrice Holmes

**********@*****.*** 321-***-**** Orlando, FL

OBJECTIVE

Eager to apply my flexibility and teamwork in the role of Customer Care Specialist, capitalizing on extensive experience in client relations and staff training. Committed to self-development and continuous training to enhance service quality and contribute to team success.

WORK EXPERIENCE

VirtuAlly, LLC Orlando, FL

Patient Safety Observer Aug 2023 - Jul 2024

• Monitored patients using virtual surveillance to provide immediate response and prevent safety incidents.

• Collaborated with healthcare teams to enhance patient safety protocols, especially for high-risk individuals.

• Implemented established safety risk assessment protocols, contributing to a reduction in patient self-harm events.

• Recorded clinical observations of patients on an hourly basis, ensuring accurate documentation of their condition. DocMJ Orlando, FL

Medical Assistant Trainer Aug 2019 - Jul 2023

• Trained new medical assistants, ensuring adherence to company protocols and elevating team efficiency.

• Conducted chart audits to identify and implement improvements, significantly enhancing record accuracy.

• Prepared patient charts with vital information, optimizing the efficiency of patient care.

• Maintained strict HIPAA compliance in managing patient medical records, ensuring confidentiality and data integrity.

• Conducted outbound calls to patients to confirm and manage appointment schedules.

• Documented patient accounts and details accurately in the Zoho. Lev Diagnostics Orlando, FL

Field Clinical Coordinator Trainer May 2022 - Oct 2022

• Facilitated integration of pacemaker/ICD transmissions and Holter hook-ups, aligning with Medicare compliance requirements.

• Enhanced market presence by promoting services strategically, leading to the acquisition of new nursing home accounts.

• Collaborated with nursing leadership to maintain compliance with Medicare regulations and generated accurate account documentation using Salesforce.

Optum Orlando, FL

Member Service Supervisor Oct 2015 - Jul 2019

• Managed a customer service team to enhance client satisfaction via process improvements and consistent performance assessments.

• Conducted weekly call calibrations with clients and account management to fortify client relations and communication channels.

• Instituted standardized procedures across departments, resulting in increased operational efficiency and reduced error rates.

• Assessed and refined team performance metrics, yielding marked improvements in team productivity.

• Provided support for member services representatives on escalated calls concerning patient prescription benefit claims.

• Mentored member service advocates, preparing them for advancement within the company. Member Service Advocate Dec 2011 - Oct 2015

• Answered incoming calls, addressing inquiries on eligibility, prescription benefits, adjudicated claims, and service authorizations from members and providers.

• Processed prescription refill orders, aiding in patient medication adherence.

• Resolved rejected claims by conducting thorough research and applying effective problem-solving techniques.

• Delivered exceptional service to both internal and external customers, focusing on first-call resolution of member and provider concerns.

• Documented member interactions accurately using the Navigator system.

• Advanced from Member Service Advocate to Member Service Supervisor, reflecting professional development and elevated levels of responsibility.

EDUCATION

Florida Metropolitan University

AS in Criminal Justice, Criminal Justice

Orlando, FL

Jul 2002

South College

AS in Surgical Technology, Surgical Technology

Orlando, FL

Present

SKILLS

Microsoft Word • Excel • PowerPoint • Customer Service • Problem-Solving • Data Entry • Leadership • Conflict Resolution • Emr • Active Listening • Computer Literacy • Effective Communication • Patience • Empathy • Customer Support • Attention to detail • Telephone Skills • Documentation Skills • Pharmacy terminology • Multitasking • Organization Skills • Technical Support • Confidentiality • Mentoring • Training • Crisis Management • Referrals

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