Dallaya Mitchell

- Facilitated the basic enrollment process for members under Medicare Part D, ensuring a seamless experience for participants.

- Led project initiatives aimed at empowering fellow agents to identify and accurately file grievances on behalf of members, promoting an efficient resolution process.

- Collaborated with a diverse portfolio of 12 or more clients affiliated with CVS Caremark, ensuring tailored service delivery and effective account management.

- Processed and submitted plan benefit overrides for both members and retail pharmacies, ensuring adherence to benefit guidelines.

- Generated and disseminated detailed explanations of benefits under Medicare Part D, providing clarity and support to members regarding their coverage.

- Assisted members in enrolling in the Medicare prescription drug program, guiding them through the necessary steps and documentation.

- Managed payment transactions, accepting payments via credit card and checking accounts, while ensuring secure and accurate processing.

- Provided support in resolving rejected and paid claims, facilitating quick resolutions to uphold service quality.

- Communicated comprehensive explanations of annual notice of change letters to members, enhancing their understanding of plan modifications.

- Addressed coordination of benefits inquiries, acting as a key point of contact for resolving complex insurance questions.

- Monitored and assessed prescription order statuses, proactively addressing any issues to ensure timely fulfillment.

- Handled discontinuations of prescriptions thoughtfully, providing members with essential information and support.

- Conducted courtesy retranslation for prescription claims, ensuring that all communication was clear and detailed.

- Explained Dispense as Written (DAW) codes to clients, clarifying their implications for prescription processing.

- Reached out to doctor offices to expedite prescriptions to local pharmacies, particularly when mail order deliveries faced delays or when members were low on medication.

- Requested new prescriptions from healthcare providers via phone, facilitating timely access to necessary medications.

- Managed controlled substances with stringent adherence to regulations, ensuring safe handling and processing.

- Liaised with local pharmacies to update members' prescription drug insurance information, maintaining accurate records.

- Submitted transfers of medications from local pharmacies to mail order pharmacies, ensuring continuity in medication access.

- Set up medications for automatic refill renewal programs, easing the prescription management process for members.

- Provided information on programs available through Medicare Part D, helping members maximize their benefits.

- Submitted both delegated and non-delegated grievances, advocating for members’ rights and needs within the system.

- Processed coverage determinations, ensuring members received the appropriate benefits based on their eligibility.

- Located in-network pharmacies within members' areas, aiding them in accessing medications conveniently.

- Assisted with premium billing inquiries for members, ensuring clarity and accuracy in all financial matters.

- Managed refunds and assisted with inactive accounts, restoring service continuity for affected members.

- Conducted research on paper claims to ensure all documentation was accurate and organized.

- Participated in project initiatives for outbound campaigns to proactively inform members about upcoming changes to prescription drugs in 2025.

- Managed a high volume of inbound and outbound calls to assist customers with delinquent accounts ranging from 30 to 180 days past due, fostering positive customer relations while addressing sensitive financial matters.

- Conducted thorough evaluations of each account, employing analytical skills to determine effective, sustainable solutions for resolving issues and enhancing customer satisfaction.

- Independently negotiated repayment schedules with customers, tailoring agreements to meet their unique financial circumstances while ensuring adherence to company policies.

- Utilized an array of collection tools and strategies provided by management, including extensions, hardship modifications, and debt programs, to optimize recovery efforts.

- Executed the collection of delinquent accounts in strict compliance with both state and federal Fair Debt Collection Practices, maintaining a commitment to ethical standards and customer rights.

- Ensured timely receipt of payments to minimize financial losses, demonstrating a proactive approach to account management.

- Oversaw the processing of ACH and debit payments, guaranteeing accuracy and compliance with payment deadlines.

- Managed a diverse range of customer interactions through inbound and outbound calls, ensuring high levels of customer satisfaction during the reservation process.

- Handled the full spectrum of reservation services, including making new reservations, canceling, and modifying existing bookings, with meticulous attention to detail.

- Ensured vehicle safety and readiness by conducting cleaning, maintenance checks, and tire inspections, upholding company standards for customer service.

- Processed payments via credit and debit cards efficiently and accurately, contributing to the smooth operation of transactions.

- Provided prompt and effective resolutions to customer inquiries, demonstrating a commitment to exceptional service delivery.

- Coordinated with multiple branches to facilitate fleet management and actively supported logistics to address customer needs.

- Transported customers to their desired destinations, ensuring a safe and pleasant travel experience.

- Managed refund requests for security deposits and returned rented vehicles, adhering to company guidelines.

- Collaborated with hotel partners to maintain the quality and availability of car fleets, enhancing overall operational efficiency.

- Assisted with car insurance reservations and quotes, providing customers with comprehensive information to support their needs and facilitate smooth transactions.

- Processed insurance claims, ensuring timely and accurate delivery of services to customers.

- Developed strategic debt repayment solutions through the arrangement of repayment schedules customized to fit individual customers’ financial situations, fostering cooperative relationships.

- Proactively contacted customers to notify them of delinquent accounts, employing persuasive communication techniques to solicit payments while maintaining a respectful approach.

- Provided expert advice to customers on necessary actions and strategies for debt repayment, enabling them to regain financial stability.

- Conducted in-depth discussions to understand the reasons for overdue payments, allowing for more effective resolution strategies.

- Utilized automated systems and computer software to locate and monitor overdue accounts, streamlining collections processes.

- Addressed a variety of customer inquiries and concerns regarding their accounts, providing clear, informative responses to facilitate understanding and resolution.