Iluminada Poggenpohl
Summary
As an accomplished team member and assistant manager with over 10 years of working experience, my career achievements have given me the opportunity to provide my diverse skills in a variety of business services for the U.S. government, regional department stores, rental properties, and customer care environments. I am a graduate in business administration with a minor in data processing and speak the Spanish language. I am an enthusiastic businesswoman with the drive and determination to resolve complex problems. I’m motivated in sharing my knowledge with leadership, team members, and clients.
Overview
15
15
years of professional experience
Work History
Customer Service Representatives II
United Healthcare
01.2024 - Current
- Assisting providers by answering questions about benefit verification, entering claims data for processing, and maintaining a good relationship with providers.
- Reviewing and resolving billing errors, claim denials, and payment discrepancies.
- Checking patient eligibility and benefit details to ensure proper coverage.
- Helping providers obtain necessary pre-authorizations for treatments.
Bilingual Customer Service Representative
Maximus
01.2023 - 05.2024
- Answer incoming calls from consumers, including the general public, prospective enrollees, and people assisting enrollees or acting on their behalf, in accordance with all performance standards, policies and procedures, and protocols, including but not limited to the confidentiality and privacy policies.
- Respond effectively to all forms of inbound and outbound contacts.
- Track and document all inquiries using the applicable systems.
- Process new applications for health care coverage via the telephone, including building tax households, household income, eligibility determinations, interpreting determinations made by the Marketplace, and enrollment into health plans.
- Transfer/refer consumers to appropriate entities according to the established guidelines.
- Process life event changes, demographic updates, unenroll requests, and special enrollment periods as requested.
- Process the fulfillment of caller requests for materials via mail, email, or download.
- Attend meetings and trainings as requested and maintain up-to-date knowledge of all programs and systems.
Customer Service Representative
Teletech Corporation
01.2011 - 08.2015
- Advised customers on products, services, and current promotions by identifying and recommending appropriate products and services based on their needs and preferences.
- Manage and resolve 50+ escalated customer complaints per day, processing returns, exchanges, and changes to service levels.
- Conducted price and feature comparisons to encourage customers to purchase items.
- Explained in detail how various items functioned and operated to customers.
- Filed information on customers pertaining to return purchases.
- Managed customer calls effectively and efficiently in a complex, fast-paced, and challenging call center environment.
- Addressed and resolved customer loan complaints empathetically and professionally.
- Processed payments, refunded, recorded important customer data, updated customer information, and de-escalated calls via active listening to identify needs and provide timely solutions.
- Gathered and verified all required customer information for tracking purposes.
Education
Bachelor of Science -
Business Administration
Skills
- Customer Service
- Microsoft Word
- Access
- Desktop Publishing
- PowerPoint
- Excel
- Teams
- Use of the Internet
- HIPPA
- AWS
- Use phone systems Genesys
Timeline
Customer Service Representatives II
United Healthcare
01.2024 - Current
Bilingual Customer Service Representative
Maximus
01.2023 - 05.2024
Customer Service Representative
Teletech Corporation
01.2011 - 08.2015
Bachelor of Science -
Business Administration