Summary
Overview
Work History
Education
Skills
Timeline
Generic

ERIC ROSAYA

Houston,TX

Summary

Skilled team player with strong background in customer service environments. Works well independently to handle assignments and always ready to go beyond basics assignments. Quick learner with good computer abilities.

Overview

19
19
years of professional experience

Work History

Quality Assurance Specialist

CVS/AETNA
07.2023
  • Medicare Quality Assurance Specialist support achieving an enhanced member experience through providing individualized coaching to customer service representatives stressing QUEST principles
  • In addition, call coaches act as an advocate for the business by measuring and monitoring the quality and effectiveness of work processes that impact customer satisfaction
  • Consult and/or work cross functionally to influence and promote change that improves the member experience Coach our team on work procedures including but not limited to proper call handling and maintaining call quality standards; Provides on-going feedback and acts as subject matter expert in addressing procedural issues Lead training sessions for designated audiences, as needed
  • Duties include: Actively engage with the curriculum design and development organization(s) to collect and coordinate subject matter expertise, to collaborate on and influence the design and development of curriculum and to ensure that the right curriculum is developed using the appropriate learning medium Conducts audits ensuring compliance with performance standards and superior outcomes (e.g., quality, accuracy, and timeliness); Performs mandatory call monitoring Identifies developing trends impacting service/engagement levels and proactively partners with appropriate parties to recommend process enhancements or solutions to avoid potential service delivery problems (e.g., quality increasing management controls, tightening procedures or addressing training needs, etc.) Reports on performance results and may provide support to leadership in the development of action plans for staff and unit effectiveness; If required, provides training to outbound staff in support of these efforts If required, may make outbound calls, respond to written inquiries, and handle “escalated” issues in support of work performed by the Personal Navigator team or leadership staff Performs effective service recovery and provides education Monitors the participation and completion of Web-based training for staff and completes appropriate follow-up with leadership Through local quality reviews and effective time management of call activity, works to improve engagement rates and first call resolution
  • Provides technical and subject matter expertise relative to policies, procedures, and customer service applications/systems tools
  • Successfully completed Leaders in Training program September 2023

Sr Customer Service Representative

CVS/AETNA
01.2023 - 07.2023

Sr

  • Customer Service serves as the Single Point of Contact for handling member service inquiries, issues and process requests received via telephone
  • Acts with fast knowledge using integrated service tools
  • Engages, consults and educates members based upon the member's unique needs, preferences and understanding of the ISM suite of services
  • In addition to traditional CSR responsibilities Sr Requirements and duties include: Ability to build a trusting relationships by taking accountability to fully understand the member’s needs
  • Ability to resolve complex issues with sensitivity and discretion
  • Uses communication skills to build relationships with both internal and external members/constituents
  • Ability to multitask and handle multiple functions and/or multiple products while maintaining and/or exceeding performance standards
  • Demonstrates professionalism and presents a positive image when interacting with members and constituents
  • Demonstrates strong member focus and utilizes all available resources to ensure prompt member satisfaction
  • Demonstrates functional expertise and leadership ability
  • Collaborates with colleagues and co-workers to deliver a world class customer experience
  • Serves as SME providing technical assistance when needed on call related issues, products, and/or system applications delivery matters
  • May participate in preparation and presentation of client specific presentations
  • May track and trend data
  • Coaches, trains and assists in the development of call center staff, as

Customer Service Representative

CVS Health / Aetna
07.2021 - 01.2022
  • Houston, TX required
  • Participates in and/or leads special projects/initiatives addressing service issues, as necessary
  • Provides technical or subject matter expertise concerning policies, procedures, and function-related applications/systems tools as needed
  • Delivers internal quality reviews
  • Provides appropriate support in third party audits when required
  • Documents and tracks all contacts, events, and outcomes with clients using appropriate systems and processes
  • Answers questions and resolves issues as a “single-point-of-contact” based on phone calls, plan sponsors, PSS/ISO, members and providers
  • Provides customized interaction based on customer preference and individualized needs, creating an emotional connection with our members by understanding and engaging the member to the fullest
  • Fully understands the member’s needs by building a trusting and caring relationship with the member
  • Anticipates customer needs
  • Provides the customer with related information to answer the unasked questions, e.g
  • Additional plan details, benefit plan details, member self-service tools, etc
  • Uses customer service threshold framework to make financial decisions to resolve member issues
  • Educates and assists customers on various elements of benefit plan information and available services created to enhance the overall customer service experience with the company (i.e., assistance with member self-service tools, Consultation Opportunities – Simple Steps, Cost of Care Tools, Natural Alternatives
  • Program, etc.)
  • Utilizes all relevant information to effectively influence member engagement
  • Takes immediate action when confronted with a problem or made aware of a situation
  • Takes ownership of each customer contact to resolve their issues and connect them with additional services as appropriate
  • Identifies member needs beyond the initial inquiry by answering the unasked questions
  • Resolves issues without or with limited management intervention
  • Provides education to members to support them in managing their health
  • Responds quickly to meet customer needs and resolve problems while avoiding over-committing
  • Other activities may include: providing claim status information, benefit coverage interpretations, and explaining plan eligibility
  • Processes claim referrals, new claim hand-offs, and escalates issues as appropriate through the system for grievances and appeals
  • Initiates out-reach/welcome calls to ensure constituents expectations are met or exceeded
  • Identifies trends and any emerging customer service issues and works to develop solutions to address potential problems and/or plan features of interest as an approach to improve understanding of benefit plans and increase post-enrollment member satisfaction
  • Partners with other departments to deliver client specific presentations
  • Coordinates efforts both internally and across departments to successfully resolve service issues and develop process improvement intended to enhance the overall delivery of service
  • Works collaboratively with colleagues to deliver the best customer experience Seeks to understand the customer, including circumstances, problems, expectations and needs
  • Asks probing questions to identify the underlying customer needs
  • Appropriately transitions conversations to explore possibilities for extending customer interactions
  • Guides members to the appropriate health resource Offers alternatives where appropriate
  • Acts with the best interest of customer in mind and central to all interactions.

Customer Service Representative

iQor inc
12.2020 - Current
  • Answer inbound calls and greet customers with energy and enthusiasm
  • Place outbound calls and communicate with energy and enthusiasm to customers
  • Build lasting relationships with clients, customers, and other call center team members based on trust and reliability
  • Understand and strive to meet or exceed call center metrics while providing excellent and consistent customer service
  • Meet department productivity and quality standards
  • Strive for first call resolution and take true ownership of customer needs and issues
  • Communicate and follow instructions for one call customer resolution
  • Deliver amazing customer service through effective and timely resolution of various customer inquiries and concerns
  • Take an active role in educating customers about our clients products and services.

Independent Driver

Mustang Delivery
03.2017 - 11.2023
  • Upheld company presentation and service standards to maintain positive company image with customers.
  • Updated logs, delivery paperwork, and required forms with accuracy
  • Loaded, secured, and checked product prior to leaving distribution centers
  • Interacted positively with customers during deliveries and when handling any problems
  • Addressed customer complaints, proactively seeking resolution to ensure repeat business.
  • Safely transported dangerous goods by complying with the applicable safety standards
  • Verified completeness and accuracy of delivery manifests to minimize errors.

Detailer

CarMax
12.2014 - 11.2023
  • Dent repair, touch-up painting, striping
  • And tinting windows
  • Operated and maintained high-pressure water hoses, steam cleaners, and chemical cleaning tanks
  • Checked individual parts for cleanliness, damage and issues with operating standards that could harm users or cause environmental problems
  • Carefully mixed, handled and used hazardous chemical solutions such as abrasives to complete skilled cleaning work.

Boiler Maker Helper

Heat and Power Boiler Service, Inc
08.2014 - 11.2023
  • Conveys tools, equipment, and parts to work area by hand or using hand-trucks
  • Cleans boilers and tanks, using scrapers and steam or water hoses
  • Holds parts for Boilermaker to fit, clamp, or weld parts in specified alignment
  • Bolts or unbolts assemblies, using hand tools, such as wrenches, screwdrivers, and prying bars
  • Removed trash and recyclables from work areas and disposed of according to proper procedures
  • Abided by all safety standards and OSHA regulations in warehouse environment
  • Collected and disposed of excess stock, defective items or obsolete materials
  • Organized work areas to reduce errors and support efficiency.

Dispatcher Campus Guard

Louisiana State University
08.2004 - 11.2023
  • Dispatches tow trucks to remove illegally parked vehicles
  • Addressed and resolved campus complaints and account issues or escalated to management
  • Received incoming calls, accessed campus personnel account information, and provided accurate and updated answers to all inquiries
  • Assisted with training and support for new dispatch members
  • Maintained grace and efficiency in fast-paced high call-volume environment with very detailed expectations
  • Followed escalation procedures to facilitate resolution for complex support issues
  • Interviewed campus visitors and callers to assess needs and entered all call information into account management system
  • Responded to campus personnel according to department guidelines
  • Updated accounts with customers' current personal information
  • Kept records of visitor interactions and transactions, recording details of inquiries, complaints, comments, and actions taken
  • Performed administrative support functions such as processing payments and reconciling accounts
  • Collected payment for customer purchases and visitor fees
  • Check identification of persons who enter facilities or grounds
  • Monitor for signs of disturbances.

Education

None - Health Sciences

San Jacinto College
Pasadena, TX

High School Diploma -

Zachary High School
Zachary
05.2003

Skills

  • Multi-line telephone operations, Call center procedures, Conflict resolution, Customer service, Problem resolution
  • Product knowledge, Data entry, Customer consulting
  • Cultural Awareness
  • Organization and Time Management
  • Interpersonal Communication
  • MS Office
  • Analytical and Critical Thinking
  • Multitasking Abilities

Timeline

Quality Assurance Specialist

CVS/AETNA
07.2023

Sr Customer Service Representative

CVS/AETNA
01.2023 - 07.2023

Customer Service Representative

CVS Health / Aetna
07.2021 - 01.2022

Customer Service Representative

iQor inc
12.2020 - Current

Independent Driver

Mustang Delivery
03.2017 - 11.2023

Detailer

CarMax
12.2014 - 11.2023

Boiler Maker Helper

Heat and Power Boiler Service, Inc
08.2014 - 11.2023

Dispatcher Campus Guard

Louisiana State University
08.2004 - 11.2023

Sr

None - Health Sciences

San Jacinto College

High School Diploma -

Zachary High School

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ERIC ROSAYA