Iesha Cruz
Summary
Member Services Representative bringing top-notch skills in oral and written communication, active listening and analytical problem-solving skills. Enhances customer experiences by employing service-oriented behaviors, understanding customer desires, and providing customized solutions to build loyalty.
Overview
9
9
years of professional experience
1
1
Certification
Work History
Member Services Specialist
Businessolver
09.2023 - Current
- Directed and controlled 401K, medical, dental, and vision benefit packages.
- Met customer call guidelines for service levels, handle time and productivity.
- Increased efficiency and performance by monitoring team member productivity and providing feedback.
- Promoted superior experience by addressing customer concerns, demonstrating empathy, and resolving problems swiftly.
- Developed and updated databases to handle customer data.
- Educated customers about billing, payment processing and support policies and procedures.
- Maintained up-to-date knowledge of product and service changes.
- Followed up with customers about resolved issues to maintain high standards of customer service.
Patient Care Advocate & Billing Representative
Accredo Health Group
09.2021 - 09.2023
- Managed order scheduling, insurance updates and claims.
- Handled customer service inquires from members, physicians and clients in which it relates to pharmacy benefits
- Evaluated effectiveness of current strategies with interdisciplinary team and utilized recommendations to make permanent improvements to care standards.
- Monitored progress and documented patient health status changes to keep care team updated.
- Upheld confidentiality requirements and regulatory compliance guidelines.
- Maintained confidentiality of patient data and condition to safeguard health information.
- Provided subject matter expertise in case management and related procedures.
- Resolved problems with communication and billing to foster seamless services.
Residential Advisor
Keystone Job Corps Center
08.2018 - 08.2021
- Provided daily supervision or assistance in monitoring student's dorm chore assignments, special recreation activities, cafeteria monitoring, transportation, and programmed activities
- Mediated conflict to provide safe and secure environment through policy enforcement.
- Participated in staff meetings and training to stay informed on policies and procedures.
- Fostered productive and supportive environment for academic and social success.
- Promoted diversity and inclusion to create welcoming and inclusive living environment for all.
- Initiated dormitory programs to foster positive relationships and safe social opportunities.
Direct Support Professional
Community Options, Inc.
07.2017 - 08.2018
- Assisted clients with daily living needs to maintain self-esteem and general wellness.
- Monitored progress and documented patient health status changes to keep care team updated.
- Assisted disabled clients to support independence and well-being.
- Maintained clean, safe, and well-organized patient environment.
- Assisted with crisis intervention to de-escalate challenging behavior and maintain peaceful encounters.
- Built and maintained rapport with clients and family members to facilitate trusting caregiver relationship.
- Entrusted to handle confidential and sensitive situations in professional matter.
- Monitored clients' overall health and well-being and noted significant changes.
Customer Service Representative
Hansen Technologies
07.2015 - 07.2017
- Provided timely and accurate information to incoming customer inquiries and product knowledge requests
- Processed customer orders, changes, and billing concerns according to department policies and procedures
- Provided important feedback to the company regarding service failures or customer concerns.
- Maintained customer satisfaction with forward-thinking strategies focused on addressing customer needs and resolving concerns.
- Provided primary customer support to internal and external customers.
- Adhered to company policies and scripts to consistently achieve call-time and quality standards.
Education
High School Diploma -
Hazleton Area High School
Hazle Township, PA06.2013
Skills
- Commercial and Private Insurance
- Claims Review
- Multitasking and Organization
- HIPAA Compliance Certification
- Billing and Collection Procedures
- Data Entry
- Payment Posting
- Scheduling
- Problem-Solving Abilities
- CRM Software
- Technical Support
- Medical Terminology Knowledge
Certification
- Driver's License
- CPR Certification
- First Aid Certification
- Accident, Life & Health Insurance License
License
Resident Producer's License
Pennsylvania License #1129665
Expiration Date: 02/01/26
Assessments
- Sales skills, Proficient, 07/01/23, Influencing and negotiating with customers
- Technical support: Customer situations, Proficient, 10/01/23, Responding to technical support situations with sensitivity
- Written communication, Proficient, 10/01/23, Best practices for writing, including grammar, style, clarity, and brevity
- Customer Service Skills, Proficient, 11/01/23, Measures a candidate's skill in evaluating approaches to customer service & satisfaction.
Languages
Spanish
Professional Working
Timeline
Member Services Specialist
Businessolver
09.2023 - Current
Patient Care Advocate & Billing Representative
Accredo Health Group
09.2021 - 09.2023
Residential Advisor
Keystone Job Corps Center
08.2018 - 08.2021
Direct Support Professional
Community Options, Inc.
07.2017 - 08.2018
Customer Service Representative
Hansen Technologies
07.2015 - 07.2017
High School Diploma -
Hazleton Area High School