FELICIA STEWART
Summary
Customer service professional with over 6 years of experience excelling in high-volume environments. Demonstrates exceptional problem-solving and communication skills, ensuring customer satisfaction through effective conflict resolution and adherence to compliance guidelines. Comfortable handling a high volume of inbound calls throughout the day using VoIP phone systems. Strong familiarity with Google Workspace, Apple products, and customer relationship management (CRM) software, with the ability to learn proprietary tools quickly. Exceptional customer service skills, with the ability to act as a member advocate, de-escalate challenging situations, and maintain a professional, friendly demeanor. Strong verbal communication skills for phone interactions, including the ability to explain benefits, processes, and next steps clearly and confidently. Understands and follows HIPAA guidelines and maintains member confidentiality at all times.
Overview
8
8
years of professional experience
Work History
GROUP BENEFITS - REMOTE
The Hartford
Plano, TX
03.2023 - Current
- Communicate policy details to clients, ensuring clarity and prompt responses.
- Identified needs of customers promptly and efficiently.
- Resolve client issues efficiently, enhancing satisfaction and trust.
- Meet daily performance goals in accuracy.
- Coordinated with brokers and employers to clarify coverage details, fostering strong relationships and ensuring client satisfaction.
- Educated employees on benefit plans and procedures, providing tailored support to resolve inquiries.
- Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
- Adhered to HIPAA regulations when handling confidential patient information.
- Worked collaboratively with other departments such as billing, coding, clinical documentation improvement specialists when necessary.
- Processed paperwork related to medical claims processing including authorizations, referrals, pre-certifications.
- Managed customer inquiries through telephone and email.
- Utilized customer relationship management software to track interactions.
- Answered incoming calls regarding membership benefits and services.
- Greeted customers in a friendly and professional manner.
- Managed customer conflicts and challenging situations by staying calm and accessing internal knowledgebases to develop strategic solutions.
- Handled customer complaints in an efficient and courteous manner.
- Presented and explained services and products to meet member needs.
- Maintained accurate records of member interactions and transactions.
- Adhered to all applicable policies, procedures, regulations, and laws.
- Assisted with customer requests and answered questions to improve satisfaction.
CLAIMS GROUP BENEFIT INTAKE REPRESENTATIVE - REMOTE
New York Life Insurance
Plano, US
02.2019 - 03.2023
- Coordinated with brokers and employers to clarify coverage details, fostering strong relationships and ensuring client satisfaction.
- Educated employees on benefit plans and procedures, providing tailored support to resolve inquiries and strengthen understanding.
- Communicated effectively through various channels, responding promptly to policy requests and demonstrating strong problem-solving skills.
- Analyzed underwriting data to identify trends, driving informed decisions that enhanced compliance and reduced risk.
- Process claims for FMLA and disabilities, ensuring compliance and privacy standards.
- Verify customer identity, enhancing security and trust in high-volume environments.
- Meet daily performance targets, contributing to efficient claims processing.
- Deliver quality service to insured individuals, improving customer satisfaction.
- Processed complex claims efficiently, ensuring accuracy and compliance, which led to timely approvals and enhanced customer satisfaction.
- Verified customer identities using robust security protocols, reducing potential fraud and safeguarding sensitive information.
- Delivered exceptional customer service to claimants, fostering trust and improving overall client experience during the claims process.
- Maintained strict adherence to HIPAA and compliance guidelines, ensuring confidentiality and legal protection for all claims handled.
COLLECTIONS REPRESENTATIVE
Conifer Health Solutions
Frisco, US
08.2018 - 02.2019
- Managed daily calls, achieving 80% success in payment plans for delinquent accounts.
- Negotiated terms to boost customer satisfaction and cut down account delinquencies.
- Accurately documented transactions, ensuring compliance and efficient collections.
- Engaged with customers to identify needs and enhance communication strategies.
- Partnered with cross-functional teams to streamline processes, enhancing client communication and fostering a supportive environment.
- Analyzed customer payment patterns to refine collection approaches, yielding noticeable gains in repayment compliance.
- Provided empathetic customer service, effectively addressing concerns and building trust to improve overall client relationships.
Education
Diploma -
Huntington High School
Shreveport, LaMedical Lab Technician -
Southern University At Shreveport
Shreveport, LaCertificate - Medical Office Assistant
Ashworth College
Lacrosse, GaSkills
- Problem Solving
- Organizational
- Multi-tasking
- Production Environment
- Attention to detail
- Time management
- Effective communication
- Documentation accuracy
- Proficiency in CRM software
- Google workspace proficiency
- Active listening
- Medical terminology
- Computer proficiency
- Excellent written communication
Timeline
GROUP BENEFITS - REMOTE
The Hartford
03.2023 - Current
CLAIMS GROUP BENEFIT INTAKE REPRESENTATIVE - REMOTE
New York Life Insurance
02.2019 - 03.2023
COLLECTIONS REPRESENTATIVE
Conifer Health Solutions
08.2018 - 02.2019
Diploma -
Huntington High School
Medical Lab Technician -
Southern University At Shreveport
Certificate - Medical Office Assistant
Ashworth College