Diane De La Cruz
Florence,AZ
Summary
Experienced Call Center Agent with strong leadership skills seeking a position in a dynamic and expanding organization. Committed to advancing organizational goals and continuously enhancing skills through practical experience. Helpful Senior Customer Service Executive possessing friendly demeanor and excellent problem-solving and communication skills. Bringing 30 years of experience increasing customer satisfaction levels and business performance by handling and analyzing complaints and designing customer service strategies. Dedicated to creating positive impression on customers to build and retain customer base.
Overview
26
26
years of professional experience
Work History
Senior Customer Service
Arise/Contractor/Self Employed
06.2022 - 02.2024
- Assist new and existing customers with medical transportation services for existing and new members
- Verified insurance prior to schedule for pickups and drop off to members medical appointments
- Contact dispatchers for members when drivers were late or no show to appointments
- Handled confidential information with sensitivity and discretion by HIPPA And Data Privacy Laws, company data security requirements.
- Addressed on average 100 inbound customer calls daily.
EPIQ Global Claims Analyst III
Digital Intelligence Systems (DISYS)
05.2022 - 06.2022
- Use proprietary software tools to access and review claim documents, enter claim decisions, and create escalations when needed
- Data entry and verification
- Follow written procedures and scripts
- Utilize documented team processes to ensure compliance with departmental standards
- Communicates immediately to leadership all obstacles to completing work
- Meets and exceeds departmental expectations for accuracy and productivity.
- Conducted thorough investigations into each claim, gathering relevant data and documentation to support decision-making processes.
- Maintained strict confidentiality with all personal data as per company guidelines.
- Managed high-volume caseloads, prioritizing tasks to ensure timely completion of all claims.
Senior Customer Service
LiveOps/Contractor/Self Employed
09.2021 - 05.2022
- Assist customers with new services, transfers, cancellations, billing options, and training on services
- Process new applications, order taking, and research for special requests
- Handled confidential information with sensitivity and discretion by HIPPA And Data Privacy Laws, company data security requirements.
- Expertly managed escalated issues through effective communication strategies leading to swift resolutions.
- Collaborated with cross-functional teams to implement new strategies and improve customer experience.
- Updated account information in each customer's record to keep data accurate.
- Oversaw daily operations of customer service department, effectively managing resources to meet targets consistently.
- Answered multi-line phones and used active listening skills to assess client's issues and challenges.
- Addressed on average 100 inbound customer calls daily.
Senior Customer Service Representative
UnitedHealth Group
01.2019 - 08.2021
- Receives inbound calls from employers, members, and brokers and finds topic and type of help caller needs such as benefits, eligibility and claims, financial spending accounts, and correspondence
- Navigate across multiple databases which requires fluency in computer navigation and toggling while confidently and compassionately engaging with caller.
- 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.
Eligibility and Enrollment Specialist
Insight Global (Contract for Willis Towers Watson)
10.2017 - 01.2019
- Handles confidential information with sensitivity and discretion by HIPAA and Data Privacy laws and company data security requirements
- Proficiently translates health and welfare terms, complex plan information, and processes into simple explanations and instructions that customers can understand and act upon.
- Updated, entered, and reviewed customer data.
- Streamlined enrollment process for increased efficiency and enhanced user experience.
- Understood and thoroughly explained services provided to customers and potential customers.
- Collected premiums on or before effective date of coverage.
- Communicated effectively via telephone, email, and in person with prospective customers.
- Finalized sales and collected necessary deposits.
Pharmacy Customer Care Specialist
Humana Inc.
02.2016 - 10.2017
- Receive, document, and resolve customer inquiries by using established best practices
- Educate callers and providers about Human's products and services over telephone.
- Reconciled cost of orders 100% by selling loyalty clubs, offering promotions and correcting issues.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Verified accuracy of customer account information and updated when necessary.
- Achieved high satisfaction rating through proactive one-call resolutions of customer issues.
Solutions Specialist
Randstad Technologies (Contract for CVS Health)
08.2015 - 02.2016
- Assist in PC refreshes, break/fix, and migrations
- Hardware/software troubleshooting and updates
- Work with both PCs and Laptops.
- Increased productivity by collaborating with management to develop process improvements.
- Conducted troubleshooting and diagnostic procedures on customer devices.
- Monitored project status and productivity while inspecting performances to decrease process discrepancies by75%.
Business Technical Support III
ASAP INC (Contract for ATT)
10.2011 - 09.2015
- Assisted with Inbound Business to Business calls configuring gateways and networks to function with owned 3rd party equipment, Set up Email clients along with educating on Billing and Product knowledge.
- Improved customer satisfaction ratings by implementing efficient troubleshooting methods and providing timely resolutions.
- Maintained up-to-date knowledge of company products, services, policies, and procedures to provide accurate information during customer interactions.
- Tracked key performance metrics to monitor team effectiveness, identifying areas for improvement and implementing targeted strategies.
- Reduced average call handling time with implementation of standardized procedures and documentation for common issues.
Advanced Technical Care Representative II
Comcast Cable
01.1998 - 07.2009
- Received approximately 100 inbound calls from customers regarding issues on Cable, Internet, and Digital Phone
- Step by Step Troubleshooting techniques with customers along with creating service tickets.
- Input all data received and created service order when needed
Skills
- 40 wpm
- Data entry
- Proficient with Microsoft Products
- Medical Terminology
- Technical background with Windows PC/laptops, basic networking, static IPs, wireless, and e-mail troubleshooting
- Complaint Handling
- Problem-Solving
- Time Management
- Attention to Detail
- Problem-solving abilities
- Excellent Communication
- Team Training
- Product and service knowledge
- Active Listening
Personal Qualities
- Self-starter, who works effectively with others or with no supervision, and strives to go above expectations.
- Excellent ability to communicate effectively using the English language in a customer service setting including verbal, written communication, and negotiation skills.
- Sharp critical thinking skills with sound judgment.
- Always maintain a positive, empathetic, and professional attitude.
Work Availability
monday
tuesday
wednesday
thursday
friday
saturday
sunday
morning
afternoon
evening
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Timeline
Senior Customer Service
Arise/Contractor/Self Employed
06.2022 - 02.2024
EPIQ Global Claims Analyst III
Digital Intelligence Systems (DISYS)
05.2022 - 06.2022
Senior Customer Service
LiveOps/Contractor/Self Employed
09.2021 - 05.2022
Senior Customer Service Representative
UnitedHealth Group
01.2019 - 08.2021
Eligibility and Enrollment Specialist
Insight Global (Contract for Willis Towers Watson)
10.2017 - 01.2019
Pharmacy Customer Care Specialist
Humana Inc.
02.2016 - 10.2017
Solutions Specialist
Randstad Technologies (Contract for CVS Health)
08.2015 - 02.2016
Business Technical Support III
ASAP INC (Contract for ATT)
10.2011 - 09.2015
Advanced Technical Care Representative II
Comcast Cable
01.1998 - 07.2009
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