Detail-oriented team player with strong organizational skills. Ability to handle multiple projects simultaneously with a high degree of accuracy.
Overview
15
15
years of professional experience
Work History
Enrollment Representative
Humana
03.2021 - 08.2023
Reviewed reports and made adjustments, additions, and deletions based on enrollment rules
Managed daily inventory and Reported inventory daily
Processed applications from members, enrolled members in company platforms, and transmitted enrollment to center for Medicare and Medicaid services.
Maintained detailed and accurate records between multiple databases and programs.
Investigated issues and created solutions for new customers.
Processed over 50 cases daily
Inbound Contact Center Representative
Humana
12.2018 - 03.2021
Received over 60 incoming calls daily from pharmacies, providers, & patients to assist with addressing broad, complex enrollment and billing issues
Entered in Prior Authorizations and Overrides for some medications to provide prescription drug coverage to Medicare beneficiaries
Addressed customer needs which included complex benefit questions, resolving issues, and educating members
Recorded details of inquiries, comments or complaints, transactions or interactions and took action in accordance to it
Escalated unresolved and pending customer grievances.
Adhered to company policies and scripts to consistently achieve call-time and quality standards.
Processed new medication and refill requests for authorization.
CPU Specialist
Humana
08.2017 - 12.2018
Resolved Issues with centers for Medicare Services (CMS) cases that cannot be fulfilled electronically
Created cases sent to CMS to reconcile member's retroactive enrollment/disenrollment in CMS Systems
Researched inquires from Medicare departments to determine necessary actions to correct member's requests
Listened and responded to customer requests and forwarded necessary information to superiors.
Intake Specialist
RxCrossroads
01.2017 - 08.2017
Accurately handled complex customer service requests as the initial point of contact, utilizing multiple administrative systems within the defined service standards
Managed multiple levels from low to high priority tasks ensuring all deadlines is met
Reported Adverse Events and Product Complaints when needed
Received incoming calls from multiple customers such as physicians and patients, and process requests by providing resolution or triage to the appropriate areas
Provided information to Physicians, Pharmacies, and Patients on product
Processed applications for assistance with prescription coverage
Customer Service Representative
Teleperformance
04.2016 - 02.2017
Connected with customers via phone/email/chat/and or social media to resolve their questions or concerns
Calmly attempted to resolve and de-escalate any issues
Escalated interactions when necessary
Responded to requests for assistance and/or possible processing payments
Tracked all call related information for auditing and reporting purposes
Provided feedback on call issues
Assisted with Identity Theft and Debit Card Fraud
Nutrition Assistant
Jefferson County Public Schools
11.2013 - 01.2017
Served meals to students from Elementary to High School
Reported Inventory
Operated Cash Register.
Maintained food and sanitation standards to prevent food-borne illness and promote health.
Assisted with preparation and serving of food in line with established nutrition guidelines.
Monitored food and beverage supplies, assisting with restocking when needed.
Environmental Associate
Norton Healthcare
03.2015 - 03.2016
Cleaned and disinfected variety of hospital areas, rooms, and restrooms, along with office suites in medical office buildings
Performed various housekeeping duties to maintain hospital in clean, orderly, and sanitary condition.
Where patient/family contact was involved, demonstrated knowledge, skills and behavior appropriate to age of patient population served
Which included children (newborn to 17 yrs), adults, and/ or elderly.
Security Officer
Securitas
10.2012 - 11.2013
Greeted vendors and visitors at arrival
Maintained daily log of activity within Loading dock
Wrote detailed reports on property damage, theft, presence of unauthorized persons and unusual incidences.
Checked identification of persons entering and exiting facility to eliminate unauthorized visitors.
Acted quickly during emergency situations to reduce opportunity for damage and injury.
Performed inspections of guests as necessary
Conducted regular patrols of key areas to spot and control security concerns.
Daycare Teacher
Okolona Child Development Center
06.2008 - 10.2012
Taught classes, presented lectures, conducted workshops and participated in other activities to further educational program.
Assisted in preparation of meals and snacks to provide children with proper nutrition.
Actively encouraged children to develop their communication, problem-solving and social skills.
Engaged with children on individual basis to build positive relationships and promote learning.
Sanitized toys and play equipment each day to maintain safety and cleanliness.
Maintained tidy environment to comply with cleanliness and sanitation standards.