Experienced in managing member interactions and inquiries with a strong emphasis on satisfaction and retention. Utilizing effective communication and problem-solving skills to address and resolve member issues efficiently. Possessing knowledge of CRM systems and best practices to ensure accurate service delivery.
Overview
40
40
years of professional experience
1
1
Certification
Work History
Member Service Agent II
GoHealth Charlotte
03.2021 - 05.2025
Assist member with Benefit review to locate a plan that fits there health needs.
Call Quality monthly average 99.8%
Stayed calm under pressure to and successfully dealt with difficult situations.
Ensured compliance with HIPAA regulations when handling sensitive patient information, protecting client privacy at all times.
Responded to customer requests, offering excellent support and tailored recommendations to address needs.
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.
Customer service
Quantum 3 Media
09.2019 - 03.2021
Review Medicare and Life Insurance options
Met customer call guidelines for service levels, handle time and productivity.
Delivered prompt service to prioritize customer needs.
Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Customer Representative
Optum Behavioral Healthcare
11.2018 - 07.2019
Managed high call volume with exceptional professionalism and efficiency.
Responded to customer needs through competent customer service and prompt problem-solving.
Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
Facilitated smooth communication between patients, insurance companies, and medical staff for seamless coordination of care.
Educated customers about billing, payment processing and support policies and procedures.
Collaborated with staff members to enhance customer service experience and exceed team goals through effective client satisfaction rates.
Maintained courteous, friendly atmosphere for guests to increase overall satisfaction and customer service standards.
Customer service
AARP Membership
07.2016 - 11.2018
Process membership request and schedule member activities
Managed a high volume of calls daily, maintaining composure under pressure while providing exceptional service.
Demonstrated excellent multitasking abilities by simultaneously handling multiple tasks such as navigating systems, taking notes on calls, and answering inquiries from clients.
Reduced call resolution time through efficient problem-solving and communication skills.
Project Implementation
Bank of America
03.1985 - 03.2015
Participated in regular training sessions to stay up-to-date on industry trends, regulatory changes, and product offerings.
Reduced wait times for customers by efficiently handling high volumes of calls and resolving issues quickly.
Assisted in fraud prevention efforts by closely monitoring customer accounts and reporting suspicious activity as required.
Kept projects on schedule by managing deadlines and adjusting workflows.
Supervised multiple projects from project start through delivery by prioritizing needs and delegating assignments.
Liaised between departments to facilitate communication and keep appropriate parties updated on project developments.
Prepared meeting agendas and minutes for distribution and record keeping.
Created job files for each project and maintained current data in each file.
Coordinated cross-functional teams to achieve seamless collaboration in achieving project objectives.
Developed high-quality documentation to support training efforts, helping employees fully understand new systems and procedures.
Actively participated in team meetings to share knowledge, exchange ideas, address challenges, and collaborate on potential solutions.
Education
High School Diploma -
East Mecklenburg
Charlotte, NC
06-1981
Skills
Patience and tolerance
Professionalism and courtesy
Building rapport
Social perceptiveness
Accomplishments
Supervised team of 18 staff members.
Resolved product issue through consumer testing.
Certification
North Carolina Medicare and Medicaid License
Licensed with several Insurance companies in several states