Customer Service & Pharmacy Benefits Specialist

DEONNA RADKE

Las Cruces, NM 575-***-**** ******************@*****.***

PROFESSIONAL SUMMARY

Highly motivated and customer-focused professional with a proven track record of delivering exceptional service and resolving complex issues. Bringing over 5 years of experience in call center and direct customer interaction roles, adept at building strong customer relationships, de-escalating concerns, and managing accounts efficiently. Proficient in a range of customer service best practices, eager to leverage strong communication, active listening, and problem-solving skills to enhance customer satisfaction and contribute to team success. SKILLS

Customer Relationship Management (CRM)

Active Listening & Empathy

Problem Solving & De-escalation

Verbal & Written Communication

Customer Account Management

Technical Proficiency (MS Office, Computer Systems) Call Handling & Support

Data Entry & Accuracy

Team Collaboration & Accountability

Typing Proficiency

Medical Terminology

Pharmacy Benefits Management (PBM)

Insurance & Coverage Explanation

Medicare Advantage

Claims Processing

WORK EXPERIENCE

Medicaid Enrollment Specialist 09/2023 – 06/2024 TEKsystems – Remote

Processed Medicaid recertifications for the State of New Mexico, ensuring accuracy and compliance for vital public services.

Customer Service Advocate 04/2022 – 09/2023

OPTUM RX – Las Cruces, NM

Assisted customers with placing orders for prescription medications, ensuring accuracy and efficiency in the ordering process.

Provided detailed explanations of complex copays, deductibles, and savings card options, helping customers understand their financial responsibilities and maximize savings. Answered in-depth questions regarding drug coverage, prior authorizations, and formulary policies, guiding customers through their benefits. Resolved customer inquiries related to pharmacy benefits, enhancing patient understanding and satisfaction.

10/2020 – 10/2021

Concentrix – Las Cruces, NM

Served as a primary point of contact for Anthem Medicare Advantage members, providing comprehensive support on benefits, coverages, copays, deductibles, and coinsurance. Assisted members with placing over-the-counter (OTC) orders, ensuring a seamless and helpful experience.

Expertly explained complex claims processes, detailing how and why claims were paid out or denied, resolving member confusion..

Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.

Maintained in-depth understanding of product information, providing knowledgeable responses to diverse questions.

Actively participated in team meetings and training sessions to stay informed about product updates and changes.

Events Specialist 09/2019 – 04/2020

Crossmark – Las Cruces, NM

Responded to diverse customer requests for products, services, and company information, ensuring a positive brand interaction.

Managed event logistics, including display setup and product demonstrations, contributing to successful promotional activities.

Greeted customers warmly and professionally, fostering a welcoming environment for sales and inquiries.

Delivery Driver 08/2007 – 07/2009

Las Vegas Sun News – Las Vegas, NV

Provided excellent customer service by maintaining a friendly and courteous demeanor during interactions, increasing satisfaction.

Met promised delivery times consistently by planning optimal routes and utilizing GPS software to avoid delays.

Maintained a positive attitude in a fast-paced, customer-focused environment, ensuring efficient and timely deliveries.

EDUCATION

Associate of Applied Science: Nursing

New Mexico State University – Las Cruces, NM

May 1994

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