Professional with strong background in customer interactions and service solutions. Highly skilled in conflict resolution, communication, and problem-solving, ensuring customer satisfaction and loyalty. Effective team collaborator, adaptable to changing needs, and consistently focused on achieving results through efficient and empathetic service. Known for reliability and proactive approach to meeting customer and organizational goals.
Overview
9
9
years of professional experience
Work History
Customer Service Representative
AAA Auto Club Group
02.2024 - Current
Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
Responded to customer requests for products, services, and company information.
Contributed to sales growth by upselling products and services based on individual customer requirements.
Collaborated with team members to streamline processes, improving response times for service requests.
Exceeded performance metrics consistently, earning recognition as a top performer within the team.
Customer Service Representative I
Health Care Support / Centene Corporation
10.2021 - 02.2024
Handling inbound calls from providers regarding the providers /members checking claims statuses, prior authorizations, pharmacy information etc
Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
Respond to telephone or written correspondence inquiries from members and/or providers within established timeframes utilizing current reference materials and available Resources
Research and identify any processing inaccuracies in claim payments and route to the appropriate site operations team for claim adjustment
Customer Care Associate
Magellan Healthcare
10.2016 - 05.2021
Communicates information regarding member eligibility, benefits, EAP services, claim status, and authorization inquiries to callers while maintaining confidentiality
Educates providers on how to submit claims and when/where to submit a treatment plan
Identifies and responds to Crisis calls and continues assistance with the Clinician until the call has been resolved
Provided crisis intervention and support during critical incidents, promoting safety and stabilization for affected individuals.
Maintained accurate documentation of client progress, interventions provided, and relevant clinical data for record-keeping purposes.
Provided referrals to connect clients with other community resources to support mental health and well-being.