Summary
Overview
Work History
Education
Skills
Awards
Timeline
Generic

JANDEL CERVANTES

Haltom City,TX

Summary

Hard-working Supervisor with exceptional experience leading teams, delivering results and exceeding expectations. Creative and motivated leader adept at utilizing exceptional design and planning strengths to accomplish complex projects. Skilled in teaching new concepts and best practice strategies.

Overview

12
12
years of professional experience

Work History

Premera Supervisor

Evolent Health
11.2020 - 11.2023
  • Guide and direct customer service team towards achieving operational goals
  • Ensure that customer service team has excellent communication, problem solving and professional phone etiquette skills for achieving customer satisfaction
  • Ensure that customer complaints are resolved in a professional manner
  • Provide supervision and technical assistance to customer service team to attain departmental and organizational goals
  • Hire and train customer service staff to deliver high class customer service
  • Determine work procedures, work schedules, and workflow for customer service staff
  • Perform annual reviews, appraisals and performance management reviews for the customer service staff
  • Ensure date the customer calls are handled and answered in a timely and accurate fashion
  • Develop standard procedures and policies for improving the service provided to customers
  • Conduct meeting with Managers to discuss about process improvements and issues
  • Maintain in-depth working knowledge of the company’s brands, systems, and processes
  • Monitor business and process metrics to measure and manage customer service effectiveness
  • Educate customers about organization’s products or services
  • Maintain communication with customers via emails, phone calls, mails, etc
  • Prepare documentation and reports on routine customer correspondence for future reference purpose
  • Update the CS Ref Tools, runs ticket reports, call reports, Adherence Report, and productivity reports
  • Creates CC Alerts and job aids to assist the agents.

Team Lead

Evolent Health
11.2017 - 11.2020
  • Submit SharePoint for Claims, eligibility, RCP, Checks, etc
  • Supports team manager and performs management duties when manager is absent or out of office
  • Provides encouragement to team members, including communicating team goals and identifying areas for new training or skill checks
  • Monitor team performance and report on metrics
  • Discover training needs and provide coaching
  • Handling complaints (from both staff and customers)
  • Responds to and resolves employee relations issues expressed by team members
  • Update P92 and P94 files
  • Is available for employees who experience works and/or personal problems providing appropriate coaching, counseling, direction, and resolution
  • Assist in training with new hire classes or uptrain current staff
  • Created Job aids to assist the team on navigate applications.

Member Services/ Claim Customer Service

Evolent Health
04.2016 - 11.2017
  • Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits and authorization status matters
  • Aid members and/or providers regarding website registration and navigation
  • Educate members and/or providers on health plan initiatives
  • Provide first call resolution, working with appropriate internal/external resources, and ensure closure of all inquiries
  • Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustment
  • Receives and places follow-up telephone calls / e-mails to answer customer questions that are routine in nature.

BUSINESS PLATINUM TELEPHONE BANKING/ Escalation Support

JPMorgan Chase & Co
08.2014 - 01.2016
  • Assist customer on their checking and saving account balance
  • Address customer with their questions or concerns about their account
  • Assist customer on quick pay, bill pay, and external transfer
  • Help customer understand fees and ways to avoid in the future
  • Provide customer with five-star Customer service
  • Recommend Products and services that would further benefit them in the future
  • Work in a group environment to make sure team goals are met as well as individual goals are met
  • Feedbacks are given monthly to help improve are overall customer service experience
  • Sent information to the customer BRM on concerns or direct contact if needed
  • Handled escalated calls from business and telephone bankers
  • Assist with BRM with questions/concern on customer account.

BILINGUAL CALL CENTER REPRESENTATIVE

GameStop Corporation
08.2011 - 08.2014
  • Assisted customers with their queries and problems by phone and e-mail
  • Established and maintained contacts with new and existing customers as per the direction of the supervisor
  • Helped customers place new orders easily
  • Order, verify, report, and assist with store issues, website inquiries, and gift cards
  • Forwarded important and serious matters to the seniors
  • Transferred urgent calls to the required departments quickly and accurately
  • Entered and updated new customer details in the customer relationship management software according to administrative guidelines
  • Achieved set targets of the company by the stipulated deadline
  • Trains new call center agents for inbound, outbound, and emails

Education

HIGH SCHOOL DEPLOMA -

KEYS LEARNING CENTER EULESS

Master of Health Administration - Medical Insurance Coding

DeVry University
Villa Park, IL
12.2024

Skills

  • Staff Management
  • Strategic Planning
  • Business Development
  • Schedule development
  • Operations Management
  • Data Analytics
  • Process Improvement
  • Data Collection
  • Product Knowledge
  • Appointment Scheduling
  • Complaint resolution
  • Call center experience
  • Medical billing knowledge
  • Follow-up skills
  • Stress Tolerance
  • Data entry proficiency
  • Patient confidentiality
  • Insurance Verification
  • Claims Processing
  • Medical office administration
  • Medical terminology expertise
  • Continuing education
  • Revenue Cycle Management
  • Organizational abilities

Awards

  • Award for being the top representative in taking customer calls, tracking, and time management at Game Stop.
  • Received award from Chase for Outstanding services and score card for the Month of February.
  • Received Certificate for 100% QA for the month of September.
  • Team that I managed was number 3 for the month of February and October.

Timeline

Premera Supervisor

Evolent Health
11.2020 - 11.2023

Team Lead

Evolent Health
11.2017 - 11.2020

Member Services/ Claim Customer Service

Evolent Health
04.2016 - 11.2017

BUSINESS PLATINUM TELEPHONE BANKING/ Escalation Support

JPMorgan Chase & Co
08.2014 - 01.2016

BILINGUAL CALL CENTER REPRESENTATIVE

GameStop Corporation
08.2011 - 08.2014

HIGH SCHOOL DEPLOMA -

KEYS LEARNING CENTER EULESS

Master of Health Administration - Medical Insurance Coding

DeVry University

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