Deondrea Cauley
Beaumont,TX
Summary
Results-driven member service representative with a strong background in customer support and issue resolution. Proven ability to educate patients on healthcare policies while fostering long-term relationships and ensuring compliance with HIPAA regulations.
Overview
18
18
years of professional experience
Work History
Member Service Representative
CVS Health
Remote
08.2025 - Current
- Assisted patients with inquiries regarding healthcare services and insurance coverage.
- Resolved customer complaints through effective communication and problem-solving techniques.
- Educated patients on healthcare policies, procedures, and available resources.
- Maintained confidentiality of sensitive patient information in compliance with HIPAA regulations.
- Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
- Enhanced patient satisfaction by efficiently addressing and resolving healthcare-related inquiries.
- Managed difficult conversations with compassion and professionalism, helping deescalate tense situations while maintaining a focus on finding resolutions.
- Increased first-call resolution rates by carefully listening to customers'' needs and providing accurate information based on their inquiries.
- Expanded knowledge on medical terminology and insurance policies through continuous learning initiatives, enhancing accuracy in communication with clients.
- Maintained accurate records of customer interactions, ensuring proper documentation within the company''s database.
- Gathered information, assessed and fulfilled callers' needs and educated on important policies and procedures.
- Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
Senior Customer Service Representative
Bread Financial
Remote
09.2020 - 08.2025
- Led team initiatives to enhance customer experience and satisfaction through effective communication strategies.
- Mentored junior representatives, fostering skill development and enhancing team performance metrics.
- Implemented new CRM software features, increasing efficiency in tracking customer interactions and feedback.
- Analyzed customer service trends to identify areas for operational improvement and strategic planning.
- Resolved escalated issues by utilizing advanced problem-solving techniques, ensuring timely solutions for customers.
- Provided backup support during peak periods or staff shortages to ensure seamless service delivery to clients at all times.
- Established strong rapport with customers, fostering long-term relationships and repeat business.
- Resolved customer service issues using company processes and policies and provided updates to customers.
- Demonstrated excellent multitasking abilities by managing multiple concurrent tasks while ensuring timely completion.
- Engaged clients in person and over phone to answer questions and address complaints.
Customer Service Representative
Focus Services Inc.
Beaumont, TX
05.2016 - 09.2020
- Resolved customer inquiries through multiple communication channels, ensuring timely and effective support.
- Collaborated with cross-functional teams to streamline operations and improve overall customer satisfaction ratings.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Handled escalated calls efficiently, finding satisfactory resolutions for both customers and the company alike.
- Responded to customer requests for products, services, and company information.
- Enhanced customer satisfaction by promptly addressing concerns and providing accurate information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Developed rapport with customers through active listening skills, leading to higher retention rates and positive feedback from clients.
- Collaborated with team members to develop best practices for consistent customer service delivery.
- Exceeded performance metrics consistently, earning recognition as a top performer within the team.
Data Entry Specialist
Health Care Solutions
Beaumont, TX
01.2012 - 05.2016
- Managed accurate entry of patient data into electronic health record systems.
- Ensured compliance with HIPAA regulations during data handling and management.
- Conducted regular audits of data entries to maintain high accuracy levels.
- Expedited insurance claim processing by effectively managing sensitive patient data, including diagnoses, treatments, and billing codes.
- Improved data accuracy by meticulously entering and updating medical records in a timely manner.
- Enhanced patient care quality by ensuring correct and up-to-date information in the electronic health record system.
- Assisted in maintaining HIPAA compliance with strict adherence to privacy regulations during data entry tasks.
- Upheld high standards of accuracy while adapting to frequent updates in medical billing codes and insurance regulations.
Data Entry Clerk
Good Pack Logistics
Beaumont, TX
02.2008 - 01.2012
- Processed high volumes of data entries with accuracy and efficiency, ensuring consistent information integrity.
- Managed inventory records using specialized software, improving tracking and reducing discrepancies.
- Collaborated with team members to streamline data entry workflows, enhancing overall productivity.
- Trained new staff in data entry protocols and best practices, fostering a culture of accuracy and reliability.
- Conducted regular audits of data entries to identify errors and implement corrective measures for quality assurance.
- Oversaw complex data projects, coordinating efforts between teams to meet deadlines and achieve targets.
- Implemented process improvements that enhanced speed of data processing while maintaining high accuracy levels.
Education
High School Diploma -
West Brook Senior High School
Beaumont, TX05-2007
Skills
- Customer service
- Client assistance
- Call center experience
- Customer onboarding
- Account management
- Dispute resolution
- Escalation handling
- Problem solving
- Relationship building
Timeline
Member Service Representative
CVS Health
08.2025 - Current
Senior Customer Service Representative
Bread Financial
09.2020 - 08.2025
Customer Service Representative
Focus Services Inc.
05.2016 - 09.2020
Data Entry Specialist
Health Care Solutions
01.2012 - 05.2016
Data Entry Clerk
Good Pack Logistics
02.2008 - 01.2012
High School Diploma -
West Brook Senior High School