Elbreshia Booker
Sunrise
Summary
Dedicated Licensed Health Insurance and Customer Service Representative with over 10 years of customer service experience and 2 years in billing and consulting. Expertise in Microsoft Word, Excel, claims processing, and compliance with CMS and HIPAA regulations. Proven success in educating Medicare Advantage members, guiding beneficiaries through enrollment, and achieving high customer satisfaction. Strong knowledge of Medicare regulations, underwriting guidelines, and relationship building with a commitment to helping clients select optimal coverage.
Overview
14
14
years of professional experience
Work History
Insurance Customer Service Representative
Humana
12.2023 - Current
- Enhanced customer satisfaction by assisting with policy inquiries and claims.
- Resolved billing discrepancies, providing timely support to improve member experience.
- Educated clients on coverage options, ensuring clear understanding of benefits.
- Maintained accurate customer interaction records within CRM systems for compliance.
- Guided Medicare-eligible consumers through enrollment, ensuring adherence to regulations.
- Verified member details and processed applications, explaining coverage change rules.
- Utilized health insurance license to recommend compliant Medicare Advantage plans.
- Coordinated with claims and clinical teams to resolve member issues efficiently.
- Assisted members with finding in-network providers and scheduling necessary appointments.
- Supported understanding of prescription drug tiers and pharmacy benefits effectively.
Aca Agent
Synergy
06.2023 - 11.2023
- Enhanced customer satisfaction by explaining product features and benefits clearly.
- Streamlined operations through effective scheduling and communication between teams.
- Resolved customer inquiries promptly, ensuring timely follow-up and issue resolution.
- Delivered training on new systems to improve team performance and efficiency.
- Guided families in ACA-compliant health insurance enrollment via Health Insurance Marketplace.
- Evaluated client needs to recommend suitable health plans in compliance with ACA guidelines.
Licensed Insurance Agent
Nations Benefits Blue Cross Blue Shield
03.2022 - 04.2023
- Enhanced client understanding of Medicare Parts through comprehensive education on functionalities.
- Clarified Medicare Advantage versus Medigap distinctions, aiding informed client decision-making.
- Ensured CMS regulatory compliance while explaining plan details to clients.
- Facilitated accurate Medicare plan applications, ensuring efficient client enrollment.
- Verified program eligibility, ensuring clients' access to special enrollment opportunities.
- Confirmed client enrollments, ensuring receipt of ID cards and formulary information.
Licensed Insurance Agent
Enhanced Health
04.2021 - 02.2022
- Achieved high client satisfaction through strong relationship management and support.
- Educated Medicare-eligible individuals about Advantage and Prescription Drug Plans.
- Identified coverage gaps via comprehensive policy reviews, recommending suitable options.
- Ensured compliance and accuracy in client insurance applications and documentation.
- Conducted needs assessments to provide cost-effective, compliant coverage solutions.
- Guided beneficiaries through accurate CMS-compliant enrollment processes.
Agent Support Specialist
Anthem
03.2019 - 06.2021
- Streamlined agent request tracking by efficiently raising support tickets.
- Resolved agent complaints through thorough investigations and timely ticket closures.
- Maintained accurate customer database while escalating inquiries to relevant teams.
- Verified product availability and guided agents through account registration.
- Enhanced product offerings by collecting and analyzing agent feedback.
- Provided Medicare information support to agents utilizing CMS/MARX resources.
Customer Service Representative / Sales Agents
Sirius Xm Radio
12.2018 - 01.2019
- Generated leads, significantly increasing sales opportunities for the company.
- Achieved sales goals consistently, driving revenue growth and market presence.
- Determined competitive pricing schedules for quotes, promotions, and negotiations.
- Prepared detailed weekly and monthly sales reports for management review.
- Delivered impactful sales presentations to diverse clients, enhancing engagement and conversions.
- Promoted company programs effectively, increasing overall customer awareness and participation.
Customer Service Representative/ Technical Support
Sg Contact Center
02.2017 - 11.2018
- Resolved billing inquiries to enhance customer satisfaction and trust.
- Educated customers on services, ensuring comprehensive understanding during each interaction.
- Troubleshot technical issues with cable boxes and internet services efficiently.
- Acknowledged and addressed customer complaints to improve overall service quality.
- Maintained detailed records of interactions, facilitating timely follow-up and service continuity.
- Diagnosed technical problems involving internet and IPTV, ensuring rapid resolutions.
Cashier/ Food Prep
Taco Bell
10.2015 - 01.2017
- Facilitated smooth transactions by accepting various payment methods from customers.
- Issued accurate receipts and processed refunds, ensuring customer satisfaction.
- Verified cash drawer amounts at shift start to ensure accurate financial handling.
- Welcomed customers, creating a positive first impression upon entry.
- Maintained orderly checkout areas, enhancing the shopping experience for customers.
- Ensured food quality and safety by following proper preparation and handling procedures.
Billing Specialist
Assured Billing And Consultant
07.2013 - 07.2015
- Improved payment collection by mailing bills and past-due notices to clients.
- Enhanced claim resolution through diligent follow-up calls for denied claims.
- Managed patient insurance inquiries, ensuring timely communication with companies.
- Resolved claim issues by tracking and addressing delays or denials.
- Documented all communications and actions to maintain accurate patient records.
- Processed and recorded payments promptly, ensuring accurate billing documentation.
Day Care Teacher Assistnt
Greater Horizon Academy
05.2012 - 06.2013
- Ensured children's safety by adhering to emergency procedures and protocols.
- Developed and led activities addressing children's diverse physical and emotional needs.
- Provided nurturing care and nutritious meals while parents attended work or school.
- Maintained hygiene by implementing effective hand-washing and cleaning techniques.
- Prepared children for school and comforted them during distressing moments.
Education
High School Diploma - undefined
Piper High School
Fort Lauderdale, FL05.2012
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Florida Career College - Miami
Miami, FLSkills
- Team player
- Fast Learner
- Customer Satisfaction
- Quality
- Medicare Advantage (Part C) Knowledge
- Medicare Part D Prescription Drug Coverage
- CMS Compliance & Regulatory Standards
- HIPAA Compliance
- Health Insurance Enrollment & Eligibility
- Understanding of Premiums, Copays, Deductibles & MOOP
- Knowledge of Provider Networks & Formularies
- Claims & Billing Issue Resolution
- CRM & Member Management Systems (eg, Humana systems, Salesforce)
- Data Entry & Documentation Accuracy
- Multi-tasking Across Multiple Systems
- Phone & Chat Support Tools
- Appointment Scheduling & Follow-Up
- Microsoft Office (Word, Excel, Outlook)
- High-Volume Call Center Support
- Conflict Resolution & De-escalation
- Active Listening & Empathy
- Clear Verbal and Written Communication
- Member Education & Plan Explanation
Timeline
Insurance Customer Service Representative
Humana
12.2023 - Current
Aca Agent
Synergy
06.2023 - 11.2023
Licensed Insurance Agent
Nations Benefits Blue Cross Blue Shield
03.2022 - 04.2023
Licensed Insurance Agent
Enhanced Health
04.2021 - 02.2022
Agent Support Specialist
Anthem
03.2019 - 06.2021
Customer Service Representative / Sales Agents
Sirius Xm Radio
12.2018 - 01.2019
Customer Service Representative/ Technical Support
Sg Contact Center
02.2017 - 11.2018
Cashier/ Food Prep
Taco Bell
10.2015 - 01.2017
Billing Specialist
Assured Billing And Consultant
07.2013 - 07.2015
Day Care Teacher Assistnt
Greater Horizon Academy
05.2012 - 06.2013
High School Diploma - undefined
Piper High School
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Florida Career College - Miami