Sarai Acevedo

The Offline Customer Support Specialist is responsible for various back office tasks that support Customer Operations. Responsibilities include completing tasks that typically require research and customer contact, resolution of complex customer requests and analyzing audit/error reports to ensure that people, process and technology are effectively supporting customer and operational business rules. The Offline Customer Support Specialist must provide exceptional customer service with strong attention to details.

MAJOR DUTIES AND RESPONSIBILITIES
Actively and consistently support all efforts to simplify and enhance customer's experience
Complete offline/back-office tasks for customer support such as mailing statements, call logs, etc.
Identify, analyze and correct errors on customer accounts in the billing system and ancillary systems as required
Support multiple billing and ancillary systems and resources i.e., ICOMS, CSG, CRM, Gateway, KM systems and Case Management Systems
Support both Residential and Small to Medium Business tasks
Support multiple “work/call types” – Handle billing, order management and technical requests from such as White Mail, Equipment Research, PPV Research, Account Corrections and Lock Box requests
Requires customer contact to complete requests where information is missing, customer requests can’t be verified, or requests that conflict with Charter business rules
Administer all Charter business rules while fulfilling customer requests
Will identify trends and provide insight into process or system enhancements
Perform all other duties as assigned.

Served in a primary leadership capacity as a subject-matter-expert and mentor. Responded to member and provider inquiries by phone and in written, regarding all aspects of WellCare business, including claims, dental and pharmacy, in a professional, timely, accurate and caring manner. Drived and supported WellCare's initiatives at the team level by interacting with peers and other internal and external business partners while demonstrating a willingness to conform to WellCare policies and procedures. Assisted in the education of new members and in the re-education of existing members regarding health plan procedures. Performed skills necessary to create a high-quality customer experience, as reflected through acceptable Quality scores. Coordinated the review of grievances to include preparing the case with all relevant documentation, scheduling the case processing the review conducted by the department’s consultant. Assisted in the education of new members and in the re-education of existing members regarding health plan procedures.

Responded to member and provider inquiries by phone and in written, regarding all aspects of WellCare business, including claims, dental and pharmacy, in a professional, timely, accurate and caring manner. Drived and supported WellCare's initiatives at the team level by interacting with peers and other internal and external business partners while demonstrating a willingness to conform to WellCare policies and procedures. Assisted in the education of new members and in the re-education of existing members regarding health plan procedures. Performed skills necessary to create a high-quality customer experience, as reflected through acceptable Quality scores. Coordinated the review of grievances to include preparing the case with all relevant documentation, scheduling the case processing the review conducted by the department’s consultant.

• WellCare Benefit Coordinator Primary responsibilities included but were not limited to receiving high-volume calls from agents with the purpose of validating information and providing specific Federal and State benefits. Answer 60-90 inbound phone queue calls per day. Provide Low Income Subsidy (LIS) Medicaid verification to Benefit Coordinators in the field. Process paper applications through the Special Needs Population (SNP) queue via OmniFlow daily. Validated 1000+ Medicaid verifications for all SNP membership on a monthly basis Answer inbound calls from members regarding Dual-eligible Special Needs Plan (D_SNP) Deeming Status. Coordination of Benefits, Third Party Liability, CAQH, Dual Membership.
• Increased customer satisfaction by resolving agents' issues.
• Exceeded goals through effective task prioritization and great work ethic.