Tosha Moon
Fallon,NV
Summary
Diligent, hard -working and ambitious Customer Service Representative specializing in 3rd Party-web assistance and Click to Chat supportive service. Highly self-motivated, Resourceful, and knowledgeable. Ability to work independently and produce effective results. Confident when collaborating with executive leadership in communications and notifications. Offers 3 + year's experience in a call center environment and gained knowledge through recent opportunity to intern (Loaned) to Workforce Management for 11 months achieving skills and experience that increases operational continuity. Has a solid work history emphasizing in Clerical and Administrative services that contribute to being diversified in various lines of business. Committed to developing the opportunity to expand personal knowledge and career growth within the company.
Overview
8
8
years of professional experience
Work History
Customer Service Representative
Optum Innovations
Fallon, NV
04.2019 - Current
- Specialized in Third Party-Web Assistance/Technical Support and Live Chat certified
- Reputable for top performing call listening sessions, qualities, and overall metrics averaging 96.00% score in Qualities for this month and over 4% Membership conversion rate
- Process death terminations for deceased policy holders
- Examine claims and Provide Policy holder/ Provider with co-payment, co -insurance and out of pocket expenses
- Proactively offer to use Bombgar application to share screens with policy holders
- Assist policy holders with Website navigation/ registration for new policy holders
- Daily usage of Siebel production to accessing policy holder's records information
- Provide Policy holder/ Provider with benefit verification and coverage inquires
- Performed services that drive best practices and optimize financial performance
- Pro-actively offer AARP membership enrollments/renewals to policy holders
- Account Maintenance and provisioning
- Fulfill all type of Product request
- Efficiently use Regulatory probing questions to determine eligibility and comply applicable laws and Regulations
- Effectively able to articulate clients needs through active listening
- Attend to all chat request policy holders' request
- Process Correspondence pieces into data base, fulfillment request, letter request billing statements, Power of Attorney, authorized user information
- Increased operational continuity through cross-training departmental functions
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Answer customer telephone calls promptly to avoid on-hold wait times
- Educate customers about billing, payment processing and support policies and procedures
- Provide detailed information on member claims status, filing instructions, payment information and coverage determinations
- Promote superior experience by addressing customer concerns, demonstrating empathy and resolving problems swiftly while maintain excellent phone etiquette to assure customer satisfaction and experience
- Provide primary customer support to internal and external customers
- Record account information to open new customer accounts
- Recommend products to customers, thoroughly explaining details
- Respond to customer requests for products, services and company information
- Recorded account information to open new customer accounts
- Recommended products to customers, thoroughly explaining details
- Responded to customer requests for products, services and company information
- Provided primary customer support to internal and external customers
Loaned/Intern
Optum Enterprise
Fallon, NV
04.2021 - 03.2022
- Communicate with operations about opportunities for additional non phone activities based on performance and agent availability
- Communicate with operations on staffing needs based on call center volume projections
- Post (Average Handling Time) ATH Reduction notification in Breeze and Siebel messaging boards for agents to get notifications
- Notify agents of Overtime opportunities by posting message in Everbrigde
- Attending to Real Time adherence (RTA) and observe agents actual state verses schedule state
- Dedicate agents to specific call groups to target lines of business that have calls in queue using Genesys Administrator Extension (GAX)
- Utilize system overrides when necessary to aid in answering incoming calls
- Communicate with operations about opportunities for additional non phone activities based on performance and agent availability
- Communicate with operations on staffing needs based on call center volume projections
- Opening Policies in IEX NICE for voluntary time off, overtime, Overtime cancellation, Planned time off, and overtime mail processing
- Analyze and interpret data coming in from Pulse to develop plans of action and direct call flow effectively and in a timely manner
- Strategic Planning of daily management with VQ's to meet daily, monthly, yearly goals of Service levels, Occupancy, Call time handling, call volumes and abandonment rates
- Analyze and interpret data for execution of Real time plays using Intraday and playbook processes
- Provide feedback to reduce errors and improve processes and performance
- Outbound scheduling and monitoring of leads available
- Saturday coverage: Presenting in Operations/agent meeting Overall daily performance results (IDP)
- Provide feedback to leadership to ensure on-phone and off-phone activity is managed efficiently throughout current day
- Record and manage shared excel spreadsheet daily with all events that took place on that day
- Developing plans of action to meet business metrics
- Identify changes in call volume and reallocate resources when workload requires, recommend real-time schedule changes, and identify efficiency opportunities
- Monitor real-time adherence to schedules and help alert and adjust for outages, staff shortages, and unplanned events
- Process scheduling request exceptions from shared Inbox in a timely manner
- Requests are for but not limited to absences, tardiness, trainings, meetings, overtime, Special projects
- Analyzed problems, identified solutions and made decisions.
- Completed research, compiled data, updated spreadsheets and produced timely reports.
- Developed business, financial and analytical skills needed for career.
- Maintained files for Outbound leads, Zone offers and Daily Reports
- Developed business, financial and analytical skills in fast-paced work environment
- Researched and reviewed information in support of daily objectives
Customer Service Representative/Hartford
PeopleShare LLC
Reno, NV
07.2018 - 04.2019
- Benefit verification
- Benefit coverage
- AARP memberships
- Account update
- Payments
- Material request
- Product request
- General program inquiry
- Utilize Regulatory questioning for Callers interested AARP's Supplement plans prior to transferring to appropriate queue
- Trained in Click to Chat: Reading and interpreting customer needs, identify key words for chat flow procedures and insure that responses to chat messages are professional answered and in a timely manner
- Grammar efficiency
Customer Service Representative/Call Center
AARP Catalyst 360 Hartford Insurance Group
Reno, NV
07.2012 - 09.2013
- General Customer service
- AR and AP
- Account reactivation
- Cancellation of health plans due to Death or non-payments
- Answer all inbound calls pertaining to AARP health plans and memberships
- Consolidate accounts, update accounts
- Membership sales and plan overviews
- Explain health benefits to members and offer help and or other services to members.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns
- Answered customer telephone calls promptly to avoid on-hold wait times
- Offered advice and assistance to customers, paying attention to special needs or wants
- Recommended products to customers, thoroughly explaining details
Receptionist / Working Council Research
Westaff, S.O.C, Securing Our Country
Minden, NV
01.2011 - 12.2011
- Greet visitors/new employees
- Fielding recruitment inquiries, connecting clients with proper departments
- Prepare postal packages for mailing, outgoing Federal Express shipments using on-line and schedule pickup; Sign or and distribute UPS/Federal Express/Airborne packages; Receive in-coming mail; Maintain company calendars, phone directory and conference room schedules; Maintain postage meter; Process Recruitment emails from public recruitment folder; Create and modify documents using Microsoft Office
- Support HR staff in assigned project- based work; Assist Operations when needed in entering employee information into SPOT system for Letters of Authorization
- Apply for background checks in Informant system for prospective employees
- Review returned reports, notifying appropriate personnel of any possible disqualifications
- Printing all reports and overseeing distribution to correct personnel
- Process all new hired employees, 25 to 50 employees each week; Enter employee information into
- SAP computer system, provide direct deposit authorizations for set up; Create employee files, scan required documents for upload to Share Point system; Maintain gym membership account information
- Process health insurance benefits into SAP; provide enrollments to Cigna for processing
- Prepare, document, and mail all COBRA notices
- Document Control administrator for ISO document control
- Managed multiple tasks and met time-sensitive deadlines
- Screened visitors and issued badges to maintain safety and security
- Answered large volume of incoming calls daily to resolve customer issues and schedule appointments
- Maintained confidentiality of information regarding clients and company
- Corresponded with clients through email, telephone or postal mail
Quality Control Inspector
Control
Carson City, NV
04.2010 - 08.2010
- Input parts by serial number and part number into data system
- Check orders for all parts
- Wire wheel parts
- Blend parts for new repair marks
- Monitored performance and generated reports detailing quality of product and defect rates
- Inspected quality of products, taking note of functionality, appearance and other specifications documenting all damage or repairs found
- Completed precise measurements using special tools
- Performed visual inspections and non-destructive tests where appropriate
- Repaired faults , reassembled products and completed additional tests
Lead Dispatch
Sierra Communications Inc
Reno, N.
06.2009 - 01.2010
- Answer multi-line phone calls
- Keep track and assist technician's in their routes
- Make customer contact requiring jobs
- Answer questions and concerns by both technicians and customers
- Oversee second dispatcher and assist with training and/or job duties
- Maintain business communication with other contractors
- Enter Technician's daily routs and appointment into scheduling application
Education
Some College (No Degree) - Psychology With An Emphasis in Substance Abuse
University of Argosy
Reno, NV (Remote)Some College (No Degree) - Medical Administration/ Billing And Coding
University of Phoenix College
Reno, NV (Remote)High School Diploma -
Robert Mc Queen High School
Reno, NV06.2003
Skills
- Creative problem solving
- Accountable and reliable/ willingness to be flexible to accommodate company needs
- Excellent communication, interpersonal, and motivational skills that build Customer Trust and Loyalty
- Adaptable and Reliable
- Ability to Multi-task, and Time management skills
- Contact Center Experience
- Exceptional Data Entry skills that allow data to be processed effectively and efficiently
- Courteous with Strong Service Mindset
- Upbeat and Positive Personality
- Efficient, Organized and Detail-Oriented
- Customer Data Confidentiality
- Planning and Coordination
- Efficient in internal software and application including and not limited to IEX, Genesy’s Administrator (GAX) , Intra-day, OMNI, Gemini, PCH Access, Siebel, Nice(both WFM tool and agent tools), Nexidia Analytics, AT&T Business Center, Tableau, Provider Express Kickout (PES) Blocking, Pulse, Emergency Blocking, Everbridge, Breeze Notifications, Provisioning manager, Sharepoint Applications and Administrative documents
- Computer proficiency in Microsoft Word, Outlook, Power Point, and Window's XP, Excel, Microsoft Edge, Acrobat Reader, Microsoft Teams, One note and Team Meets
Timeline
Loaned/Intern
Optum Enterprise
04.2021 - 03.2022
Customer Service Representative
Optum Innovations
04.2019 - Current
Customer Service Representative/Hartford
PeopleShare LLC
07.2018 - 04.2019
Customer Service Representative/Call Center
AARP Catalyst 360 Hartford Insurance Group
07.2012 - 09.2013
Receptionist / Working Council Research
Westaff, S.O.C, Securing Our Country
01.2011 - 12.2011
Quality Control Inspector
Control
04.2010 - 08.2010
Lead Dispatch
Sierra Communications Inc
06.2009 - 01.2010
Some College (No Degree) - Psychology With An Emphasis in Substance Abuse
University of Argosy
Some College (No Degree) - Medical Administration/ Billing And Coding
University of Phoenix College
High School Diploma -
Robert Mc Queen High School
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