JADA JOHNSON

• Oversee and assist 25-30+ calls per day which involves researching standard procedures, and providing information to associates during call assistance.
• Schedule weekly coaching sessions with associates for call audits to discuss areas of improvement.
• Design learning modules for associates to implement more efficient learning styles to prevent client callbacks by 50%.
• Resolve/reprocess claims by checking procedure code errors, calculating policy benefits, and reissuing reimbursement checks.
• Create and present projects to adhere to business needs.
• Increase monthly metrics up to 30% by analyzing and tracking member feedback to measure successes and improvements needed.
• Work collaboratively with clients in an empathic manner to assess and de-escalate concerns, and work through closing open cases/tasks weekly.

• Manage call volume of 25-35+ calls per day to provide member support, resolving complex issues such as but not limited to: claims processing, prior authorizations, appeals, and benefit-related inquiries.
• Collaboratively work with network providers via phone, email, and fax to adjust client medical claims.
• Resolved member issues efficiently and effectively with a focus on first-call resolution; increasing team performance trends by 30%.
• Respond to client emails within the two business day turnaround, assisting with policy inquiries and/or case follow-ups.
• Maintain 5-10 outreach calls per day for follow-ups to maintain a 90% turnaround time status and decrease client callbacks.
• Utilize support CRM system to manage members' insurance plans including, but not limited to: possessing strong empathy for clients, quoting benefits, and obtaining needed member information/documents.
• Developed a strong referral network of representatives, administrators, and providers.

Key Highlights & Accomplishments:

• Assisting all member's needs in a timely fashion while remaining in the top 50 percentile of advisors in the department, ranking 100% in Voice-over-customer (VOC) surveys monthly.
• Nominated Excellence Award to take on role as Team Lead Specialist.
• Maintain a 90% Turnaround Time Status (TAT) during every quarter on a consistent 6-month plus time frame.

• Manage a call volume of 45-50+ customers per day to provide internet and landline tech support and issue resolution including but not limited to: troubleshooting, scheduling technician visits, and coordinating the shipment of equipment.
• Utilize the Salesforce (CRM) system to coordinate sales operations including but not limited to: shipping equipment, upgrading/downgrading packages, adding new plans, and scheduling technician visits.
• Collaborate with the sales and billing team departments to modify customers’ service plans as necessary.
• Implement strong interpersonal and resolution skills to de-escalate customer's concerns.
• Serve as a Lead Tech Representative to train, develop, and mentor newly hired employees.
• Took on a leadership role for 6+ months within the technical department.

Key Highlights & Accomplishments:

• Awarded Representative Agent of the Month for achieving 100% on VOC customer satisfaction surveys every quarter.
• Achieved Top 100% performance recognition on multiple occasions throughout Fiscal Year 2020-2021.

• Managed a call volume of 30+ customers per day to provide customer service support to business account holders; core duties were focused on: maintaining detailed knowledge of products, plans, and promotions. Utilizing strong interpersonal, communication, and suggestive/cross-selling methods to drive sales.
• Proven track record of consistently high performance in the role; self-motivated, driven, enthusiastic with an eagerness to work as a team player; self-starter and independent thinker.

Key Highlights & Accomplishments:

• Maintained an average customer service satisfaction rating of 90% throughout employment.

• Managed the fulfillment of prescription medications for 30+ customers per day within a fast-paced retail pharmacy while supporting in-store, online, and drive-thru operations.
• Utilized an EMR system (EPIC) to document patients’ medical history and demographic information.
• Trained, mentored, and developed newly hired Pharmacy Technicians on daily operations, policies, and procedures.
• Verified customers’ insurance eligibility and worked closely with insurance providers to resolve discrepancies and coverage issues.
• Led inventory audits to confirm the number of medications on hand aligned with the inventory management system while removing expired medications.
• Executed financial management by processing multiple methods of payment for purchases using a Point-of-Sale (POS) system.
• Followed and maintained compliance with all HIPAA regulations and guidelines.

Key Highlights & Accomplishments:

• Earned required Pharmacy Technician Certification (PTCB) through Rite Aid after scoring 90% on final assessment.