Bianca M Garza
CC,USA
Summary
Customer Care Representative with notable background in customer service, demonstrating strong problem-solving and communication skills. Experienced in providing top-notch support to customers, resolving inquiries efficiently and maintaining high levels of satisfaction. Proven ability to make significant improvements in customer experience by applying proactive listening and empathy in interactions.
Overview
20
20
years of professional experience
Work History
C&S DSNP Navigator
United Health Care
06.2022 - Current
- Resolve escalated and complex calls/ claim adjustments/ issues with members that front line advocates are unable to resolve or need assistance on, working directly with the business partner to make decisions regarding claim reconsideration, prior authorizations, and appeal considerations.
- Research complex issues across multiple databases and work with support resources to resolve member issues and or partner with others to resolve escalated issues.
- Meet the performance goals established for the position in areas of conversation effectiveness, call quality, member satisfaction, first call resolution, proactive member engagement, lower cost rx alternative, provider steerage to In network provider, efficiency.
- Complete outbound calls to close the loop with members who express dissatisfaction with issues resolution or service via the post call survey after speaking with advocate.
- Work with partners including medical, clinical, financial, behavioral and rx to resolve issues as needed.
Retention specialist
Spectrum
08.2015 - 05.2022
- Customer service skills
- Microsoft skills
- Professionalism and strong work ethic
- Critical thinking, problem solving.
- Providing a resolution for customers.
Sales rep/ store assistant managing
Cricket wireless
01.2014 - 08.2015
- Customer service
- Leadership
- Sales/ quotas
- Fast learning
- Adaptive skills
Provider/ caregiver
United Home Health
02.2007 - 01.2014
- Caregiver
- Patient care
- Home health care
- Worked closely with and maintaining professional relationships.
Sales associate/stocker
Stripes
01.2005 - 01.2007
- Sales
- Leadership
- Teamwork
- Self-management
- Customer service
Education
High School -
Harlingen High School North
01.2007
Skills
- Complex problem resolution
- Call center operations
- Claims processing
- Database research
- Partner collaboration
- Customer service
- Performance metrics
- Outbound communication
- Case management
- Critical thinking
- Conflict resolution
- Time management
- Multitasking capacity
- Attention to detail
Awards And Acknowledgements
- I have been praised for always going beyond for my members. During my peer to peers my supervisors and team leads have stated I have demonstrated my caring nature and show where I am always putting my members first.
- I have been praised for my magnificent work ethics, my willingness to learn and help others, my ability to always stay positive and performing at the levels needed or above goal.
Timeline
C&S DSNP Navigator
United Health Care
06.2022 - Current
Retention specialist
Spectrum
08.2015 - 05.2022
Sales rep/ store assistant managing
Cricket wireless
01.2014 - 08.2015
Provider/ caregiver
United Home Health
02.2007 - 01.2014
Sales associate/stocker
Stripes
01.2005 - 01.2007
High School -
Harlingen High School North
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