Guillermo Ramos
Los Angeles,CA
Summary
Knowledgeable and dedicated customer service professional with extensive experience in the Third Party Administration industry. Solid team player with outgoing, positive demeanor and proven skills in establishing rapport with clients. Motivated to maintain Participant satisfaction and contribute to company success. Specialize in quality, speed and process optimization. Articulate, energetic and results-oriented with exemplary passion for developing relationships, cultivating partnerships and growing businesses.
Overview
14
14
years of professional experience
Work History
Senior Participant Services Representative
Motion Pictures Industries Pension and Health Plan
Studio City, California
12.2023 - Current
- Assisted members with inquiries about pension and health plan benefits.
- Communicated policy updates to members through various channels effectively.
- Collaborated with team members to resolve member issues promptly.
- Provided training to new staff on service protocols and systems usage.
- Utilized customer relationship management software to track member requests effectively.
- Cultivated relationships with teammates to assist customers with inquiries or resolve problems.
- Responded to customer inquiries via email promptly and professionally.
- Assisted customers in troubleshooting issues with account access and services.
- Maintained up-to-date knowledge of company policy and services for effective support.
- Escalated complex issues to senior management for further review.
- Participated in training sessions to enhance product knowledge and customer service skills.
- Monitored emails queues and responded quickly to customer requests.
- Identified customer needs and provided appropriate solutions.
- Resolved customer complaints in a timely manner.
- Provided technical support to customers via email and phone.
- Shared feedback with team and offered suggestions for customer experience improvements.
- Documented all incoming emails for future reference purposes.
- Communicated with healthcare providers to clarify billing discrepancies and claim status.
- Resolved customer inquiries related to claims status and payment details promptly.
- Worked collaboratively with providers' offices to ensure timely reimbursement on submitted claims by providing missing documentation or correcting errors that caused delays in payment processing.
- Responded promptly to customer inquiries regarding claim status or other issues.
Participant Services Representative
Motion Picture Industry Pension & Health Plans
Studio City, CA
01.2018 - Current
- Delivered exceptional customer service to every Participant by leveraging extensive knowledge of Health and Pension benefits and creating welcoming, positive experiences.
- Recorded actions taken, issues resolved and benefits information to effectively manage Participant accounts.
- Promoted superior experience by addressing Participant concerns, demonstrating empathy and resolving problems swiftly.
- Responded to Participant requests, offering excellent support and tailored recommendations to address needs.
- Developed highly empathetic client relationships and earned reputation for exceeding service standard goals.
- Educated Participant about premium and pension payment processing and support policies and procedures.
- Answered questions about eligibility determinations and plan options.
- Verified insurance coverage by telephone to Health Providers for proper reimbursement of benefits and estimate patients' financial responsibilities.
- Answered inbound calls from existing and future policyholders to answer inquiries and discuss insurance options.
- Displayed consistent, positive attitude towards Participants, peers and other personnel, even during high-stress situations.
- Delivered excellent customer service, resulting in consistent 100% Quality Assurance rating
- Handled over 50 calls per shift retrieving Participant data and providing relevant eligibility, pension and health benefits information.
Customer Service Representative
Capital Brands
Northridge, CA
08.2012 - 01.2018
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Answered customer telephone calls promptly to avoid on-hold wait times.
- Updated account information to maintain customer records.
- Clarified customer issues and determined root cause of problems to resolve product or service complaints.
- Responded to customer requests for products, services and company information.
- Used company troubleshooting resolution tree to evaluate technical problems and find appropriate solutions.
- Recommended products to customers, thoroughly explaining details.
- Handled over 90 calls per shift signing up new customers warranties , retrieving customer data, presenting relevant product information and cancelling services
Education
High School Diploma -
Van Nuys Senior High School
Van Nuys, CA06-1987
Skills
- Professional telephone demeanor
- Complaint resolution
- Medical terminology knowledge
- Recordkeeping strengths
- Service standard compliance
- Technical support
- Policy communication
- Issue resolution
Timeline
Senior Participant Services Representative
Motion Pictures Industries Pension and Health Plan
12.2023 - Current
Participant Services Representative
Motion Picture Industry Pension & Health Plans
01.2018 - Current
Customer Service Representative
Capital Brands
08.2012 - 01.2018
High School Diploma -
Van Nuys Senior High School