Deseray Justice
Hous
Summary
Dynamic Customer Care Representative with extensive experience at CVS Specialty Pharmacy, excelling in problem resolution and relationship building. Proven ability to enhance customer satisfaction through effective communication and technical troubleshooting. Recognized for managing high call volumes while maintaining accuracy in data entry and fostering a supportive team environment.
Experienced with resolving customer inquiries effectively. Utilizes communication and empathy to build rapport and ensure satisfaction. Knowledge of troubleshooting and issue resolution.
Customer care professional with proven history of enhancing customer satisfaction and addressing inquiries efficiently. Focused on team collaboration and achieving positive outcomes, adaptable to changing needs. Skilled in communication and conflict resolution.
Professional in customer support with strong communication and problem-solving skills. Adept at managing inquiries, resolving issues, and ensuring customer satisfaction. Known for teamwork, adaptability, and achieving results under changing conditions. Skilled in conflict resolution, empathy, and time management.
Overview
7
7
years of professional experience
Work History
Customer Care Representative
CVS SPECALITY PHARMACY
10.2024 - Current
- Fill prescriptions: Prepare prescriptions for new and refill requests, and dispense medication to patients.
- Process insurance: Process insurance claims for prescriptions.
- Prepared compounded medications using sterile and non-sterile processes.
- Answer phone calls: Answer phone calls from customers and arrange for them to speak with pharmacists.
- Enter patient information: Enter patient information into a computer system.
- Assisted pharmacists in accurately dispensing medications to patients, ensuring compliance with dosage instructions and safety protocols.
- Provided exceptional customer service by answering inquiries, resolving issues, and providing medication information to patients.
- Maintained patient records and confidential information in accordance with HIPAA regulations.
- Collaborated with healthcare professionals to verify prescriptions, resolve discrepancies, and ensure proper patient care.
- Educated patients on proper medication usage including dosage instructions, potential side effects, and drug interactions.
- Operated computer systems for data entry purposes.
- Handled cash transactions accurately while adhering to established procedures.
- Collaborated with other pharmacy staff members to optimize workflow efficiency.
- Aided in the management of pharmaceutical waste disposal processes following regulatory guidelines.
- Informed customers about generic alternatives or cost-saving options for their prescribed medications.
- Demonstrated strong attention to detail when verifying prescription orders for accuracy.
- Supported pharmacists during medication therapy management sessions by gathering relevant patient information.
- Maintained knowledge of current pharmaceutical products available on the market.
- Counseled customers on the proper use of medical devices and supplies.
- Assisted in the coordination of medication deliveries to patients' homes or healthcare facilities.
- Managed and updated patient profiles, ensuring accurate information for prescription refills.
- Performed routine maintenance tasks on pharmacy equipment and reported any malfunctions to appropriate personnel.
- Participated in ongoing training programs to stay up-to-date with new medications, regulations, and industry trends.
- Collaborated with healthcare providers to obtain prior authorizations for prescribed medications when necessary.
- Assisted in conducting inventory audits to ensure accuracy and minimize discrepancies.
- Utilize analytical and problem solving skills to investigate, test, and troubleshoot system features.
- Demonstrated excellent communication skills when interacting with patients from diverse backgrounds.
- Safely handled hazardous substances according to established protocols.
- Achieved high levels of customer satisfaction through attentive service and prompt resolution of issues.
- Provided support during medication recalls by identifying affected products, notifying customers, and facilitating returns or replacements.
- Investigated insurance coverage options for customers, maximizing their benefits while minimizing out-of-pocket expenses.
- Ensured compliance with all safety standards related to handling/compounding/dispensing medications.
- Demonstrated proficiency in using pharmacy software systems for prescription processing.
- Developed strong relationships with regular customers/patients through personalized interactions.
- Supported pharmacists during immunization clinics by preparing vaccines/administering injections/ providing education.
- Assisted with a variety of inquiries, concerns, requests, and complaints in a professional and tactful manner.
- Educated members on plan procedures, benefits, and services, maintaining a calm and helpful demeanor even when dealing with complaints.
- Maintained a "willing to assist" attitude and ensure consistent quality service throughout the workday.
- Met and exceeded call center metrics, including call volume, quality scores, schedule adherence and NPS.
- Supported members or providers on routine or complex issues involving eligibility, benefits, claims, pre-treatment reviews (prior authorizations), medical claims and appeals status calls for denied claims/pre-treatment reviews.
- Accurately document all calls and interactions.
- Achieved individual performance goals aligned with call center objectives.
- Engaged and collaborate with other departments to enhance overall service delivery.
- Demonstrated personal responsibility and accountability through meeting attendance and schedule adherence expectations.
- Reviewed, analyzes and directs resolution of complex claims issues.
- Served as a Subject Matter Expert to Claims Customer Service Representatives and other internal departments.
- Documented all communications involving staff, Veteran, and provider contacts.
- Managed multiple task lists in accordance within directed timelines.
- Maintained updated knowledge of software applications, Claims trends, and Claim CSRs’ procedures and processes.
- Complied with HIPAA regulations to protect privacy of health information.
- Consistently met department productivity and performance metrics.
- Managed and prioritized daily workflow queues to ensure timeliness standards are met.
- Identified and reports any potential quality or fraud issues to management.
- Practiced professional and concise communication in writing and by phone.
- Handled high volume of incoming calls (180+) with a positive and professional demeanor, ensuring each caller receives a timely response.
- Accurately recorded and documented caller information.
- Managed time effectively to balance high call volumes with the need to provide thorough and satisfactory resolutions to each caller.
- Worked closely with team members and supervisors to ensure a cohesive and supportive work environment, sharing insights and feedback for process improvements.
- Followed established scripts and company guidelines to ensure consistent and accurate communication while maintaining a personalized approach.
Customer Support Specialist
Cigna
01.2020 - 10.2024
- Provided specialized clinical pharmacy services to patients in a hospital setting.
- Collaborated with healthcare professionals to optimize medication therapy and improve patient outcomes.
- Conducted comprehensive medication reviews and made recommendations for therapeutic interventions.
- Developed and implemented evidence-based protocols and guidelines for medication use.
- Assisted in the development of formulary management strategies to ensure cost-effective prescribing practices.
- Contributed to quality improvement initiatives by analyzing medication-related data and implementing interventions for improvement.
- Managed drug information inquiries from healthcare professionals, providing accurate and timely responses.
- Collaborated with pharmacists in training programs by precepting students or residents during their clinical rotations.
- Participated in research projects evaluating the effectiveness of different drug therapies.
- Ensured compliance with regulatory standards related to pharmaceutical care.
- Evaluated new medications for inclusion into the hospital formulary based on safety, efficacy, and cost- effectiveness.
- Provided counseling to patients regarding proper use of medications including dosage instructions and potential side effects.
- Served as a resource person for other healthcare professionals regarding drug interactions or compatibility issues.
- Conducted medication utilization evaluations to identify opportunities for cost savings or improved outcomes.
- Experience in fast-paced customer-facing positions: you have worked email or phone support before and can independently assess, manage and prioritize support requests based on need (i.e. priority levels, deadline) and risk.
- Passion for solving technical problems to help others I work deeply to understand customers' perspectives to assess their needs and define technical solutions to help them achieve their goals.
- I may encounter problems or situations that we have not seen before – you are comfortable with partnering with the customer to find a solution and document learnings.
- Excellent communication skills I can explain technical concepts to both technical and non-technical audiences and can communicate and empathize with stakeholders to drive issues to resolution.
- Technical Prowess I pick up new technology quickly and love learning how things work.
- Team player passionate about uplifting and collaborating with others to ensure the team and customers are successful.
- Collaborated with insurance providers to obtain prior authorizations for medications not covered by formulary..
- Served as a liaison between pharmacy department and other departments within the hospital.
- Provided drug information updates during staff meetings or continuing education sessions for healthcare professionals.
- Answered phones, emails, and live chat from customers
- Professionally responded to customer inquiries.
- Identified, escalating priority issues, and reporting to high-level management.
- Followed up on complicated customer interactions where required.
- Recorded details of customer interactions (proficiently and accurately)
- Developed rapport with customers, with an upbeat and positive attitude.
- Performed researches to determine ownership and validity of charged off debt.
- Contacted customers to collect payments and/or documentation necessary to allow orders to be completed.
- Ensured documentation meets company guidelines required to approve installation order.
- Processed secure customer payments, and/or creates payment arrangement in accordance with policy.
- Basic understanding of the billing statements.
- Utilizes established escalation procedures to expedite prompt resolution.
- Worked in a fast-paced, structured, dynamic and high-transaction environment, with the ability to maintain composure in stressful situations and manage and diffuse angry or upset customers.
- Consistently met or exceeded established goals and performance metrics.
Life Insurance Agent
Ehealth
06.2018 - 01.2020
- Provided service to clients’ changing insurance needs by selling life, health, and disability insurance.
- Established productive working relationships with clients.
- Developed bases for long-term sources of clients.
- Compiled to lists of prospects.
- Determined clients’ particular needs and financial situations by scheduling fact-finding appointments and determining the extent of present coverage and investments.
- Ascertained clients’ long-term goals.
- Developed a coordinated protection plan by calculating and quoting rates for immediate coverage action and long-term strategy implementation.
- Communicated with adjusters.
- Obtained underwriting approval by completing application for coverage.
- Completed coverage by delivering policy, planning future follow-up visits, and evaluations of needs.
- Provided continuing service by providing direct deposit forms, processing changes in beneficiary, and analyzing policy loan applications.
- Provided death benefits by delivering policy proceeds and reassessing client needs.
- Updated job knowledge by participating in educational opportunities, maintaining personal networks, and participating in professional organizations.
- Enhanced insurance agency reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
- Took full ownership of chat interactions, researching and resolving complex issues to minimize member effort.
- Proactively identified common pain points and escalate recurring issues to improve the chat experience.
- Managed multiple concurrent chat interactions while maintaining accuracy and efficiency.
- Provided empathetic, solutions-oriented responses to member inquiries about healthcare benefits, claims, billing, and provider navigation.
- Ensured all chat interactions are handled with professionalism, clarity, and attention to detail.
- Followed structured workflows and best practices to enhance efficiency and resolution times.
- Identified opportunities for process improvements to reduce member frustration and improve satisfaction.
Education
Bachelor of Science - Business Administration And Management
San Jacinto College
Pasadena, TX11-2026
Skills
- Customer service
- Inbound customer service
- Data entry
- Call center experience
- Complaint handling
- Problem resolution
- Relationship building
- Customer relations
- Product knowledge
- Billing coordination
- CRM software
- Time management
- Multitasking and organization
- Empathy and patience
- Active listening
- Verbal and written communication
- Phone etiquette
- Task prioritization
- Technical troubleshooting
Timeline
Customer Care Representative
CVS SPECALITY PHARMACY
10.2024 - Current
Customer Support Specialist
Cigna
01.2020 - 10.2024
Life Insurance Agent
Ehealth
06.2018 - 01.2020
Bachelor of Science - Business Administration And Management
San Jacinto College
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