Jessenia Martinez
Indianapolis,IN
Summary
Dedicated customer service professional with over 8 years of experience delivering high-volume, empathetic support in healthcare and insurance environments. Proven ability to resolve member grievances and appeals while effectively navigating pharmacy systems such as Express Scripts, ensuring clear explanations of benefits to enhance member understanding. Expertise in managing over 50 inbound and outbound calls daily while upholding professionalism, accuracy, and compliance with HIPAA standards. Reliable liaison between members, providers, and internal teams, characterized by strong communication skills, meticulous attention to detail, and an unwavering commitment to customer satisfaction.
Overview
10
10
years of professional experience
Work History
Customer Service Representative II
MTC
05.2023 - 11.2025
- Notified investigator sites, sponsors, and affiliates of laboratory results, sponsor-designated flags, and test cancellations in accordance with the Statement of Work (SOW).
- Monitored, tracked, and resolved accession holds; communicated delays to Supervisors and Project Managers.
- Updated databases with accurate information and coordinated additional testing requirements.
- Provided phone and email support to investigator sites and sponsors, addressing project-related inquiries.
- Ensured timely compliance with management communications, meetings, and Standard Operating Procedures (SOPs).
- Assisted in implementing and supporting global processes and procedures to enhance efficiency and consistency.
- Tracked and reported operational metrics within established timelines.
- Documented, resolved, and escalated service failures as necessary to ensure timely issue resolution.
- Served as a liaison between internal teams and external clients to facilitate smooth communication and collaboration.
- Communicated investigator site needs during discussions of new policies and procedures.
- Promoted a culture focused on patient safety, promptly addressing and escalating any safety-related concerns.
- Ensured investigator needs were considered and incorporated before implementing new processes or procedures.
Customer Care Specialist
Northwestern
09.2022 - 04.2023
- Achieved timely resolutions for member grievances and appeals within established guidelines.
- Facilitated prescription access by navigating pharmacy systems like Express Scripts.
- Assisted members and providers with routine service inquiries effectively and efficiently.
- Enhanced member understanding by explaining Explanation of Benefits (EOB) details clearly.
- Educated members on insurance plans, benefits, and available resources comprehensively.
- Delivered exceptional customer support, managing 50+ calls daily with professionalism and empathy.
Medical Office Receptionist
Indiana University Health
03.2018 - 08.2022
- Ensured HIPAA compliance by safeguarding patient confidentiality and securing PHI.
- Accurately registered new patients and updated profiles with necessary information.
- Collected comprehensive medical histories to enhance clinical documentation accuracy.
- Verified insurance coverage and communicated details to authorized personnel effectively.
- Enhanced patient satisfaction by managing front desk operations and inquiries professionally.
Insurance Agent
American Income Life Insurance Company
01.2016 - 03.2018
- Ensured timely policy renewals through efficient processing and accurate updates.
- Fostered long-term client relationships by educating them on comprehensive insurance benefits.
- Maintained compliance through accurate transaction documentation and regulatory adherence.
- Sold life, health, and disability insurance products tailored to client needs.
- Clarified policy features, empowering clients to make informed insurance decisions.
- Recommended policy updates based on thorough analysis of existing coverage.
Education
Associate Degree - Science Education
Vincennes University
Vincennes, IN06-2018
High School Diploma -
Ben Davis University High School
Indianapolis, IN06-2018
Skills
- Customer engagement management
- Inbound and outbound call handling
- Excellent Work Ethic & Positive Attitude
- Active Listening & Objection Handling Skills
- Strong Communication & Interpersonal Skills
- Microsoft Office Suite (Word, Excel, PowerPoint, Publisher)
- Bilingual: Fluent in Spanish and English (Speaking & Writing)
- Time Management & Organizational Skills
- Data Entry & Record Keeping
- Driven and Goal-Oriented Professional
- Critical thinking
- Conflict resolution
- Professional telephone demeanor
- Complaint resolution
Accomplishments
- Awarded Employee of the Month within two months of employment for outstanding performance and customer service.
- Successfully promoted products and encouraged customers to upgrade their existing plans, contributing to increased sales.
- Conducted follow-up calls to ensure customer satisfaction and resolve any post-purchase concerns.
- Professionally handled 80+ calls per day, delivering accurate information and support to maintain a high level of customer satisfaction.
- Boosted product sales by 12%, which directly contributed to a 20% increase in annual revenue.
Languages
English – Native or Bilingual Proficiency
Spanish – Native or Bilingual Proficiency
Timeline
Customer Service Representative II
MTC
05.2023 - 11.2025
Customer Care Specialist
Northwestern
09.2022 - 04.2023
Medical Office Receptionist
Indiana University Health
03.2018 - 08.2022
Insurance Agent
American Income Life Insurance Company
01.2016 - 03.2018
Associate Degree - Science Education
Vincennes University
High School Diploma -
Ben Davis University High School