ARIANA COOK
Riverside,CA
Summary
Diligent Customer Service Representative bringing top-notch skills in oral and written communication, active listening, and analytical problem-solving skills. Able to enhance customer experiences by employing service-oriented behaviors, understanding customer desires, and providing customized solutions to build loyalty. Knowledgeable and dedicated customer service professional. Solid team player with an outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain customer satisfaction and contribute to company success. Specialize in quality, speed, and process optimization. Articulate, energetic, and results-oriented with an exemplary passion for developing relationships, cultivating partnerships, and growing businesses. As well as handling Grievances & Appeals.
Overview
11
11
years of professional experience
Work History
Medicare Customer Service Representative
Molina Healthcare
Riverside
11.2023 - Current
- Enhanced customer satisfaction by efficiently addressing and resolving Medicare-related inquiries.
- Streamlined claim processing for quicker reimbursements, diligently reviewing submitted documentation.
- Provided exceptional support to Medicare beneficiaries, guiding them through coverage options and plan details.
- Facilitated timely issue resolution, coordinating with diverse departments and healthcare providers as needed.
- Enhanced grievance appeals efficiency by streamlining processes and implementing best practices.
- Reduced case backlog significantly through diligent review and resolution of pending grievances.
- Improved customer satisfaction rates by providing timely and empathetic responses to appeals inquiries.
- Conducted thorough investigations for complex cases, ensuring fair and accurate outcomes.
Simple IRA Advisor
CB&T Capital Group
08.2022 - 07.2023
- Process Simple IRA plans for employers
- Educate employers on benefits
- Outbound calls up to 60 daily.
- Enhanced client satisfaction by providing expert financial advice and personalized investment strategies.
- Increased client portfolio performance through diligent market research and analysis for optimal asset allocation.
- Processed and handled Grievance and Appeals.
SR Housing Analyst- Case Manager
San Diego Housing Commission
08.2021 - 06.2022
- Created and updated Excel spreadsheets detailing latest information regarding Rental Assistance.
- Developed appropriate care plans for at-risk individuals and high-risk families.
- Answered telephones to assist customers and resolve issues.
- Conversed with people from different cultures daily, providing high level of respect and patience with each interaction.
- Input communication with applicants into computer system to facilitate future clarification and knowledgeable support.
- Performed careful reviews of applicant data to ascertain compliance with eligibility criteria for economic assistance.
- Explained eligibility details and affordability options to patients with kindness and respect.
- Increased efficiency by streamlining data analysis processes and implementing automation tools.
- Filed Grievances and appeals on the renters behalf
Member Services Specialist
Rose International-Kaiser Permanente
11.2019 - 01.2021
- Managed over 50 calls per day
- Delivered functionality assistance via phone and online service platforms
- Recommended specific products and services in alignment with individual needs, requirements, and specifications
- Continuously surpassed customer service standards while ensuring compliance with call volume objectives
- Completed training and worked effectively under high-pressure client services environments
- Evaluated customer information to explore issues, develop potential solutions and maintain high-quality service
- Learned all internal systems and related service role duties to provide skilled team backup in handling customer demands
- Assisted members with correcting account, service and system issues by educating on required forms and technical processes
- Entered customer interaction details in "CHATS" to track requests, document problems and record solutions offered
- Communicated with people from various cultures and backgrounds, using active listening and interpersonal talents to ensure consistency
- Advised members of different coverage types and insurance
- Filed Grievances and appeals
Member Care Representative- Remote
Nordstrom
10.2015 - 10.2018
- Managed over 60 calls per day
- Process orders from customers via telephone calls or live chat
- Provide customers with critical product information that ensures customer satisfaction
- Successfully troubleshoot and resolve all customer service inquiries or issues arising from Internet and catalog
- Track customer packages
- Effectively provide support for escalated customers
- Troubleshoot with customers who have trouble placing orders
- Communicated accurate information about promotions, customer programs and products, providing exceptional customer service and driving retention
- Fielded customer questions regarding available merchandise, sales, current prices and upcoming company changes
- Filed grievances and appeals for the members
Internship Student
Brotman Hospital
01.2013 - 04.2013
- Helps health care providers and patients by greeting them in person and by phone; answering questions and requests
- Provide information and advice regarding drug interactions, side effects, dosage, and proper medication storage
- Maintains pharmacy inventory by checking pharmaceutical stock to determine inventory level; anticipating needed medications and supplies; placing and expediting orders; verifying receipt; removing outdated drugs
- Maintains safe and clean pharmacy by complying with procedures, rules, and regulations
- Protects patients and employees by adhering to infection-control policies and protocols
- Organizes medications for pharmacist to dispense by reading medication orders and prescriptions; preparing labels; calculating quantities; assembling intravenous solutions and other pharmaceutical therapies
- Maintains records by recording and filing physicians' orders and prescriptions
- Generates revenues by calculating, recording, and issuing charges
- Ensures medication availability by delivering medications to patients and departments
- Provided consultations and answered inquiries from patients, healthcare professionals and physicians regarding drugs, potential side effects and specified use
- Restocked pharmacy shelves with current merchandise to drive consistent peripheral sales
- Consulted with insurance company representatives to complete claims processing, resolve concerns and reconcile payments
- Assisted patients in minimizing medical expenses by recommending generic alternative prescription medications
- Performed daily data entry
- Managed over 25 calls per day
Education
Associate of Applied Science - Diagnostic Medical Sonography
West Coast Ultrasound Institute
Ontario, CA12.2023
High School Diploma -
George Kiriyama Adult School
Gardena, CA02.2011
Skills
- Customer Service
- Decision Making
- Written Communication
- Itineraries
- Behavioral Health
- Troubleshooting
- Processing Customer Requests
- Travel insurance
- Client amenities
- Creativity
- Policy Knowledge
- Grievance Handling
- Case Analysis
Timeline
Medicare Customer Service Representative
Molina Healthcare
11.2023 - Current
Simple IRA Advisor
CB&T Capital Group
08.2022 - 07.2023
SR Housing Analyst- Case Manager
San Diego Housing Commission
08.2021 - 06.2022
Member Services Specialist
Rose International-Kaiser Permanente
11.2019 - 01.2021
Member Care Representative- Remote
Nordstrom
10.2015 - 10.2018
Internship Student
Brotman Hospital
01.2013 - 04.2013
Associate of Applied Science - Diagnostic Medical Sonography
West Coast Ultrasound Institute
High School Diploma -
George Kiriyama Adult School