Customer Service Representative

SUMMARY

EXPERIENCE

BALIYA

DARDA

240-***-**** • ***********@*****.***

Dedicated customer service professional with over 12 years of experience in member support, client relations, and customer assistance. Adept at handling inquiries, resolving issues, and ensuring seamless service experiences in remote and hybrid environments. Strong background in healthcare, staffing, and insurance industries with expertise in policy interpretation, case resolution, and client satisfaction. Skilled in process optimization, service quality improvement, and effective communication to enhance member and customer engagement. Member Service Representative (Remote)

TheKey Mar 2023-Nov 2024

Provided remote support to members, addressing inquiries regarding home healthcare services, eligibility, and benefits.

Assisted in resolving complex member concerns while ensuring compliance with healthcare policies and regulations.

Educated members about service options, financial assistance programs, and care coordination.

Utilized CRM systems to log member interactions for continuity of service. Increased response efficiency, and decreased average resolution time by 18%. Awarded for exceptional member satisfaction and advocacy. Client Support Specialist (Hybrid)

Manpower Group Aug 2019-Feb 2023

Served as a key point of contact for clients, assisting with staffing solutions, onboarding, and workforce management.

Delivered timely support to address concerns, ensure contractual adherence, and facilitate seamless hiring processes.

Designed client engagement strategies to improve communication and satisfaction with services.

Significantly improved the workflow processes to ensure better service delivery. Trained new team members on client support protocols and best practices. Ensured operational efficiency and worked with the team on process improvements. Customer Service Representative

United Health Group Mar 2012-Jul 2019

Assisted customers regarding healthcare plan questions, claims processing, and interpretation of policy.

Provided step-by-step guidance on benefits enrollment and coverage options. SKILLS

EDUCATION AND TRAINING

Handled escalations by addressing complex challenges with professionalism and efficiency. Trained customers with preventive care programs and wellness programs. Maintained high accuracy in documenting customer interactions and case resolutions. Member Assistance & Advocacy

Healthcare Policy Interpretation

Client Relationship Management

Service Optimization

Escalation & Conflict Resolution

Workforce Support & Coordination

Remote & Hybrid Customer Service

CRM & Case Management Systems

Process Improvement Strategies

Client Onboarding & Engagement

Communication & Active Listening

Problem-Solving & Decision Making

Insurance & Claims Assistance

Team Collaboration & Leadership

Montgomery College

High School Diploma

Ballou High School

Contact this candidate