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Skills

  • Office equipment proficiency
  • Senior leadership support
  • Direct sales
  • Client portfolio management
  • Shipping and receiving understanding
  • Appeals processing and issue resolution
  • Promotional support
  • Materials transport
  • Contract development
  • Data evaluation

Work Experiences

  • Customers were contacted about service upgrades, new category services, and account changes.
  • Lead on-site and off-site customer support teams across multiple time zones.
  • Increased customer satisfaction ratings by providing valuable insights into customers' needs and expectations.
  • Worked as a liaison between customers and retail buyers to expedite orders and meet customer demands.
  • Exceeded one year service goals using customer service, sales, and employee management best practices.
  • Cultivated meaningful relationships with customers and drove business development by delivering product knowledge.
  • Kept track of requests, problems, and solutions by documenting conversations with customers.
  • Ranked as the most effective in optimized out of 10 representatives.
  • Explained billing procedures to customers, processed payments, and assisted with payment option setup.
  • Shared detailed information about Workday options to assist customers in making decisions.

Summaries

  • Customer Service Representative with extensive experience in the procedure industry who is friendly and dedicated.
  • Metric regulations and procedures are second nature to me.
  • Medicare Representative with a 18-year track record in customer service and a strong aptitude for working in remote environments with little supervision.
  • Expert in both individual and team roles, as well as training and mentoring new employees on company goals.
  • Work quickly to understand, document, and resolve customer issues, ensuring customer satisfaction while meeting stringent business goals.
  • Service-oriented and quality-focused, with 2 years of Miscellaneous experience and a track record of success.
  • Connecting with business customers to meet account needs, drive growth, and increase retention is a strength.
  • Motivated to keep customers happy and contribute to the company's success.
  • Customer Service Representative with a strong desire to improve customer satisfaction and contribute to the company's overall success.
  • Trained in the use of Tableau and has in-depth knowledge of client relations.

Accomplishments

  • Improved team compliance rate from 40% to 79% by implementing guidelines that simplify adherence to Medicare eligibility rules.
  • Trained and mentored new representatives on Medicare guidelines and plan structures, contributing to a 8% improvement in team performance metrics.
  • Improved customer satisfaction scores by 63% by coaching team members to focus on empathetic active listening during complex Medicare inquiries.
  • Processed 3 worth of claims annually for Medicare subscribers, maintaining a recovery rate for erroneous payments above 34%.
  • Standardized the response flow for Medicare escalations, cutting problem resolution time by 46% across 13 service departments.
  • Led a 5-member team responsible for ensuring compliance with Medicare regulations, resulting in a 51% reduction in audit discrepancies.
  • Utilized CRM tools to manage and track Medicare customer interactions, achieving a 56% increase in issue resolution within several months.
  • Resolved billing discrepancies between external insurance providers and Medicare beneficiaries, recovering an average of 6 monthly in unpaid claims.
  • Identified and rectified claim discrepancies alongside medical providers and CMS, saving 14 annually in overpaid claims.
  • Spearheaded initiatives aimed at educating beneficiaries on potential plan offerings during the Annual Enrollment Period, leading to 5% growth in account enrollments.

Affiliations

  • Fellowship with the Geriatrics Advisory Committee – Focused on creating and delivering services tailored to Medicare-eligible populations.
  • Graduated from the Healthcare Compliance Certification Program, specializing in Medicare regulatory standards.
  • National Career Development Association (NCDA) – Participated in sessions related to improving communication skills and client service for Medicare beneficiaries.
  • Participated in America’s Health Insurance Plans (AHIP) discussion panels relevant to Medicare Parts A-D.
  • Certified Medicare Trainer – Ensuring accurate and effective Medicare plan communication and provider services for customer support agents.
  • Congressional Knowledge Action Partnership (CKAP) - Initiative to stay informed about Medicare legislation that impacts customer experience.
  • Society of Insurance Compliance Professionals (SICP) – Focused on enhancing legal and regulatory compliance within the Medicare claims space.
  • Participant, National Council of Aging (NCOA) Medicare outreach events to increase knowledge of client needs.
  • Member, American Association for Medicare Supplement Insurance (AAMSI) – Participated in annual conferences to stay updated on the latest Medicare changes and regulations.
  • Volunteer Educator for the Medicare Rights Center, delivering educational workshops to senior citizens on Medicare plan and enrollment options.

Certifications

  • Microsoft Office Specialist (MOS)
  • Licensed Independent Insurance Agent (LIIA) - standard
  • CompTIA Security+
  • Certified Professional in Healthcare Quality (CPHQ) – National Association for Healthcare Quality
  • Medicare Compliance Training Certification - Cedar Works
  • Certified Patient Accounts Manager (CPAM) - American Association of Healthcare Administrative Management (AAHAM)
  • Certified Healthcare Financial Professional (CHFP) from Healthcare Financial Management Association (HFMA)
  • SHRM Certified Professional (SHRM-CP)
  • National Medicare Training Program (NMTP) Certificate - initiative
  • Certified Health Insurance Navigator (HIN) - Cedar Works

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