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Felice Ross

Felice Ross

Dallas,TX

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Quote

It is never too late to be what you might have been.
George Eliot

Summary

Organized, results-oriented, and dependable candidate with a passion to provide quality service to both internal and external clients seeking to reenter the workforce to improve client relations, sustain organizational growth, and support operations, while being successful at managing multiple priorities with a positive attitude and willingness to take on added responsibilities to meet team goals.

Skills

  • Needs Analysis - ADP Workforce Now; Peoplesoft; Kronos
  • CRM software expertise - Salesforce
  • Data Analysis - SQL; EXCEL; Query ; Tableau; Cognos
  • Account Servicing - RxClaim (AS400); Microsoft Office 365
  • Client Services
  • Staff Training
  • Performance Improvement
  • Product knowledge
  • Conflict resolution
  • Problem-Solving
  • Flexible and Adaptable
  • Data Entry
  • Cultural Awareness
  • Decision-Making
  • Attention to Detail
  • Good Telephone Etiquette
  • Written Communication
  • Organization and Time Management
  • Multitasking Abilities
  • Teamwork and Collaboration
  • Analytical and Critical Thinking
  • Maintenance and Repair
  • Self-Motivated

Work History

Configurations Benefit Setup Rep III

CVS HEALTH CORPORATION
06.2020 - 10.2021
  • Configured over 500 prescription benefits packages in compliance with client SLAs.
  • Researched, diagnosed, and resolved configuration conflicts and improved client satisfaction by efficiently addressing and resolving benefit plan discrepancies.
  • Adhered to production deadlines.
  • Organized and lead special projects as needed.
  • Mentored and assessed peers.
  • Increased customer satisfaction by reducing and resolving 95% plan discrepancies in timely manner.
  • Enhanced company reputation by providing exceptional internal customer service and support.

QA/Test Benefits Setup Rep III

CVS HEALTH CORPORATION
04.2016 - 09.2018
  • Reduced negative customer impact by 98% through QA analysis and promoting over 900 cases per year into live production.
  • Conducted regular audits on benefits data, ensuring accuracy and compliance with regulations and performed root cause analyses to correct plan conflicts.
  • Managed diverse portfolio of 20 clients, to include high profile and high visibility clients, ensuring that each received tailored solutions aligned with their specific requirements.
  • Acted as main point of contact in manager’s absence by advising peers, communicating with leaders and sitting in on management meetings.
  • Collaborated with cross-functional teams to develop new strategies for decreased plan disruption.
  • Contributed to success as subject-matter-expert for various processes.
  • Assisted in training new hires and offered ongoing support to help them reach their full potential.
  • Conducted regular audits on benefits data, ensuring accuracy and compliance with regulations

Test Benefits Setup Rep II

CVS HEALTH CORPORATION
06.2014 - 04.2016
  • Conducted detailed test analysis for new implementations and maintenance of business cases
  • Assisted in process improvement projects, leading to significant time savings without compromising quality or accuracy of work completed.
  • Optimized workflow processes, allowing for more efficient use of resources and reduced turnaround times on projects.
  • Prioritized case management queue of more than 20 tasks per day for multiple clients.
  • Ensured service level agreements and performance guarantees were met by testing and validating benefit plans and insuring configurations were in compliance with standard and customized protocols.
  • Exceeded performance targets through diligent work ethic and focus on results-driven tasks.
  • Collaborated with peers and cross-functional teams to clarify client's needs and expectations.

Sr. Benefits Specialist

CONEXIS Inc
10.2010 - 05.2012
  • Minimized 90% escalations; provided call takeovers and lead representation
  • Administered rate changes, modifications and EDI eligibility reports
  • Responded to customer inquiries via telephone and written correspondence, regarding employee benefits, provider contracts, and claims.
  • Prepared and presented contract renewals, OE setups, and detailed reports with account information.
  • Ensured compliance with federal and state regulations, minimizing risk of legal issues and penalties.
  • Educated employees on their benefit options, empowering them to make informed decisions about coverage.
  • Managed open enrollment periods, ensuring timely communication and smooth transitions for employees.

Education

Associate of Applied Science - Industrial Maintenance Tech

Texas State Technical College
Waco, TX
04.2008

Associates of Applied Science - Electronics and Computer Engineering Technology

Remington College
Garland, TX
02.2001

Licenses and Certifications

General Lines Life and Health Insurance License - Active since April 2013

Overview

11
11
years of professional experience

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Felice Ross