Empathetic communicator with extensive experience in customer service. Known for effectively managing high-volume calls while educating clients on healthcare benefits. Committed to maintaining high standards of service and enhancing customer understanding.
Overview
14
14
years of professional experience
Work History
Medicare Customer Service Representative
Maximus Federal
Winchester, KY
09.2024 - Current
Managed 100+ incoming calls from consumers, including the general public and prospective enrollees, while adhering to performance standards and protocols.
Guided beneficiaries through Medicare inquiries, delivering precise information and effective solutions.
Educated clients on Medicare plans and eligibility requirements, improving understanding and satisfaction.
Documented interactions in CRM systems, maintaining detailed records for compliance and future reference.
Responded promptly to high volumes of calls, demonstrating adaptability in fast-paced environments.
Maintained strong working knowledge of Medicare regulations, ensuring accurate information dissemination to clients.
Supported department goals by consistently meeting or exceeding established metrics related to call quality, timeliness, and accuracy.
Fostered strong customer relationships through empathetic communication and reassurance during difficult circumstances.
Analyzed account activities to detect and escalate potential fraud or abuse incidents for further investigation.
Evaluated Part A, Part B, and DME claims, executing transfers as necessary to optimize claims processing.
Healthcare Customer Service Representative
Pearl Interactive Network
Winchester, KY
08.2022 - 05.2023
Facilitated patient understanding of healthcare systems and insurance benefits to enhance user experience on healthcare.gov.
Managed 100+ calls while maintaining accurate records of customer interactions and feedback.
Utilized CRM software to track patient communications and follow up on outstanding concerns promptly.
Trained new team members on customer service protocols, fostering a knowledgeable workforce.
Analyzed health insurance applications and provided detailed information on plan options to enhance customer understanding.
Led initiatives to evaluate tax credit opportunities and Medicaid options for clients. Oversaw comprehensive reviews of insurance alternatives to enhance client understanding. Facilitated informed decision-making regarding healthcare coverage.
Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
Met customer call guidelines for service levels, handle time and productivity.
Customer Service Representative
Amazon.com Services
Winchester, KY
10.2012 - 05.2022
Managed 100+ calls, chats, and emails daily from customers and colleagues
Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
Provided coaching and mentoring to new hires, contributing to their successful integration into the team.
Assisted colleagues in navigating challenging situations by sharing expertise and offering guidance when requested or needed.
Handled escalated calls, chats, and emails calmly and professionally, ensuring that even highly dissatisfied customers felt heard and supported throughout the process.
Implemented effective communication skills to deescalate high-tension situations, fostering positive relationships between customers and the company.
Utilized advanced problem-solving abilities to identify creative solutions for atypical client concerns.
Conducted thorough follow-ups with customers post-resolution to ensure satisfaction and identify any opportunities for further improvement in the service provided.
Participated actively in ongoing professional development opportunities to stay current on industry best practices and enhance personal skillset.