Carlene Emile Rogers
North Lauderdale ,FL
Summary
Customer service professional with over 5 years of experience in high-volume call centers. Achieved a 95% customer satisfaction rating while managing over 80 calls daily. Skilled in CRM software, conflict resolution, and technical troubleshooting.
Overview
10
10
years of professional experience
Work History
Pharmacy Customer Service Representative
Cigna
Remote, FL
07.2023 - Current
- Fielded telephone inquiries on authorization details, ensuring accurate information for plan members.
- Prepared and distributed denial letters outlining reasons and guiding appeal measures.
- Analyzed medical records to determine approval of authorization requests.
- Provided drug coverage information to patients and healthcare providers, facilitating prior authorizations.
- Resolved customer complaints efficiently to enhance service quality.
- Conducted quality assurance reviews of medication orders for accuracy.
- Assisted customers with prescription inquiries and medication-related information.
Registered Pharmacy Technician
Geniusrx
03.2018 - 05.2023
- Processed high-cost medications, including self-administering and diabetic oral and injectable options, ensuring proper handling and patient education.
- Entered and processed patient prescriptions into internal system, ensuring accuracy and compliance with pharmacy protocols.
- Assisted pharmacist in filling prescriptions and addressing patient inquiries on medications to enhance customer satisfaction.
- Answered incoming phone calls and addressed questions from customers and healthcare providers.
Pharmacy Helpdesk
Envision RxOptions
04.2016 - 09.2018
- Assisted with rejection resolutions and overrides for pharmacy claims, enhancing claim approval rates.
- Responded to member inquiries regarding co-pays for drugs and formulary options based on plan structure, improving member satisfaction.
- Facilitated the initiation of medication prior-authorizations to streamline the process for healthcare providers.
- Ran test claims to see what medication will be covered by member plan from brand medications to tier1 generic medications.
- Collaborated with patients and benefit coordinators to clarify drug coverages, ensuring accurate information dissemination.
Education
High School Diploma -
Sheridan Technical College
Hollywood, FL01-2014
Skills
- Regulatory compliance and privacy laws
- Customer service and consulting
- Quality assurance
- Adaptability and conflict management
- Technical proficiency in pharmacy software
- Data accuracy and tracking complaints
- Problem resolution
Timeline
Pharmacy Customer Service Representative
Cigna
07.2023 - Current
Registered Pharmacy Technician
Geniusrx
03.2018 - 05.2023
Pharmacy Helpdesk
Envision RxOptions
04.2016 - 09.2018
High School Diploma -
Sheridan Technical College