SHAWNEE N WORMLEY
Waco,TX
Summary
Results-driven Member Service Advocate with experience in customer service and problem resolution. Demonstrated strengths include effective communication, relationship-building skills, and commitment to high-quality member support. In previous roles, made significant impact improving member satisfaction and cultivating loyal client relationships through active listening and solution-oriented approach.
Overview
5
5
years of professional experience
1
1
Certification
Work History
Member Service Advocate
GuideWell, Florida Blue
Jacksonville, FL
05.2021 - 12.2023
- Educated customers on the importance of staying up to date on their premiums and other costs associated with their policies.
- Maintained accurate records of all verifications, including date of service, procedure codes, diagnosis codes.
- Resolved customer inquiries regarding benefit eligibility in a timely manner.
- Provided assistance with claims processing when needed, including filing appeals as necessary.
- Informed customers about billing procedures, processed payments, and provided payment option setup assistance.
- Collected deposits or payments and arranged for billing.
- Reviewed and verified health insurance benefits for patients prior to their scheduled appointments.
Member Service Representative
CVS/caremark
Dallas, Texas
02.2019 - 08.2022
- Answered customer inquiries and provided accurate information regarding products and services.
- Provided excellent customer service to resolve customer complaints in a timely manner.
- Resolved complex problems by working with other departments to provide solutions that meet customer needs.
- Assisted customers with making payments or establishing payment plans to bring accounts current.
- Maintained knowledge of current promotions, exchange guidelines, payment policies and security practices.
Education
Diploma - Pharmacy Technician
TEXAS STATE TECHNICAL COLLEGE
WACO, Texas12.2009
Associates of Arts - General Studies
MCLENNAN COMMUNITY COLLEGE
WACO, Texas05.2005
Diploma -
WACO HIGH SCHOOL
WACO, Texas01.2000
Skills
- Member retention
- Membership renewals
- Issue Resolution
- Product Sales
- Service Upselling
- Database Management
- Customer Service
- Microsoft Office expertise
- Calm Under Pressure
- Medical terminology knowledge
- Credit card payment processing
- Billing Adjustments and Refunds
Certification
- Pharmacy Technician License, 11/30/14, Texas State Board of Pharmacy, KILLEEN, TEXAS
- Pharmacy Technician Certification (CPhT), 07/31/13, Pharmacy Technician Certification Board, WACO, TEXAS
Timeline
Member Service Advocate
GuideWell, Florida Blue
05.2021 - 12.2023
Member Service Representative
CVS/caremark
02.2019 - 08.2022
- Pharmacy Technician License, 11/30/14, Texas State Board of Pharmacy, KILLEEN, TEXAS
- Pharmacy Technician Certification (CPhT), 07/31/13, Pharmacy Technician Certification Board, WACO, TEXAS
Diploma - Pharmacy Technician
TEXAS STATE TECHNICAL COLLEGE
Associates of Arts - General Studies
MCLENNAN COMMUNITY COLLEGE
Diploma -
WACO HIGH SCHOOL
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