Ayala Gandy

• Analyzed member feedback to identify trends and improve communication strategies.
• Collaborated with cross-functional teams (DS) to enhance service delivery and member engagement.

* Employed at BCBS all 5 states IL, TX, OK,MT, NM

I handled Secure Message, that included BVA, assisting members with benefits, claims/complex claims, appeals, prior authorization, prescriptions and claim adjustments

My job was to empathize by reading their inquiry and reaching out to them if they needed, and ensuring they were helped in a timely manner.

I also worked on the MAP que as and ECA, which is handling provider appeals and clinical documents getting them to the correct department. I have been put on projects such as working overflow. I was in this job role for 5 years and now back on phones as a customer advocate II.

I now take calls from all 5 states, working with providers and members and I have completed pharmacy training so I can assist with that line of business as well.

I have shadowed the Customer Loyalty Team and would be able to perform that task if needed. I have been with the company for 8 years in September and plan to grow my knowledge to be able to assist members and provide accurately and timely.

• Implemented best practices for content development, aligning communications with organizational goals.
• Evaluated communication tools to optimize outreach efforts and improve member experience.
• Met deadlines to provide relevant information quickly to staff and general public.
• Managed numerous simultaneous assignments while maintaining a high level of organization and attention to detail.
• Adapted quickly to new beats or assignments, demonstrating flexibility and commitment to excellence in journalism.
• Analyzed viewer feedback to steer content strategy, aligning more closely with audience preferences.

• As a Customer Advocate I spend 90% of my time sitting down speaking with members on the phone, and handling written inquiries when needed. I work/adjust claims, benefits, call providers, start appeals, and I have been a learning coach for about a Year. My role is to assist members in a timely manner with the accurate Information about their policies and coverage, I have worked in customer service for 6+ years and have been with BCBS going on 3 years and currently skilled in IL, TX, and OK. I have to be capable to enter data timely and have great typing skills. My strong point with my current position, is communication skills and able to adapt to new surroundings and learn new things, also being able to handle irate/disgruntled customers, who can at time come down hard on us as CA’s. My current job has a lot of fast changes as well, so being able to learn and apply new things in a quick manner is a must, which brings the skill multitasking, which working with BCBS is a must. I’m a personable person and have a outgoing personality, and love working with my team.

• My job as a tele tech, is to be able to sit 90% of my 12 hour shift and preform checks on patients who are being monitored on a screen to help prevent further health issues that are being addressed. As well as creating and tarring down charts for new and discharged patients that will follow them throughout their entire hospital stay.

• Certified Nurses Aid My responsibilities included helping the residents with their daily living activities, charting, documenting, and performing routine vitals for patient's well-being. As an aid we also had to strive for resident and family satisfaction, being that was their home and we worked for them.

• My job was to handle and count money as well as making sure the money got to the correct place at the end of shift, along with presenting outstanding customer service, and easing disgruntle customers. I was in charge of enrolling and establishing customers in memberships and starting new lines of credit with the store. There would be occasional times where we were in charge of running and operating the store front, and always had to look and be presentable, and lead with a smile, being that we were the first face a customer would see.