Dedicated and personable Customer Service Representative with a proven track record of establishing rapport with clients across various industries. Solid teamwork skills, positive attitude, and unwavering commitment to customer satisfaction. Unique ability to empathize with others and think outside the box to better understand and meet the needs of those served. Articulate, enthusiastic, and results-oriented professional with a genuine passion for building lasting relationships and contributing to company success.
Overview
10
10
years of professional experience
1
1
Certification
Work History
Benefit Activation Specialist
Clearview Health Group
Remote
10.2025 - 04.2026
Company Overview: Temprorary remote project for Clearview Medicare. Company was established just a few years ago but thrives in the Medicare Advantage industry, Assisted licensed sales agent in completing the application process for newly enrolled customers during the open enrollment period.
Verified enrollees personal and demographic information was accurate for a safe and easy application experience.
Boosted customer retention rates by delivering personalized support throughout the activation process.
Enhanced customer experience by providing thorough product demonstrations and guiding clients through activation processes.
Managed multiple simultaneous activations while maintaining strict adherence to deadlines and quality standards.
Streamlined onboarding for new customers by creating clear, concise activation guides and instructional materials.
Answered policy questions when applicable.
Liaison between the enrollees and licensed sales agent when needed.
Maintained detailed records of all activations completed, allowing for accurate reporting and analysis of trends over time.
Member Service Representative
United Healthcare
Las Vegas, NV
09.2022 - 05.2025
Accessed patient information through various software applications, maintaining strict confidentiality to remain compliant with HIPAA regulations.
Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
Kept records of customer interactions or transactions, thoroughly recording details of inquiries.
Documented and managed patient information in computer systems.
Some of those systems include Facets, Maestro, I-CUE, Community Care and many other state systems.
Scheduled and confirmed patient appointments with patients and healthcare professionals to meet members needs.
Connected with members case managers, doctor's and pharmacies to help coordinate care when necessary.
Assisted with benefit questions, and value added services including finding community resources.
Referred patients to appropriate professionals and services.
Supported hospital and clinic operations using customer service skills and detailed system knowledge, including using company knowledge bases to follow proper procedures.
First call resolution was our goal. Promoted high customer satisfaction by resolving problems with knowledgeable and friendly service.
Referred unresolved customer grievances and appeals to designated departments for further investigation.
Handled complaints with prompt, courteous service to uphold professional reputation.
Followed up with customers about resolved issues to maintain high standards of customer service.
Worked closely with members and their providers to resolve any billing issues for the member, and, or any claims issues for the providers.
Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures.
Helped with self service options including online registration, troubleshooting, and navigating members portal when applicable.
Remote member service advocate for one of the top medical insurance companies in the world, United Healthcare Community Plan. Assisting Medicaid members with getting access to health care and other long term care services for multiple states.
Remote member service advocate for one of the top medical insurance companies in the world, United Healthcare Community Plan. Assisting Medicaid members with getting access to health care and other long term care services for multiple states.
People Center Specialists
H&R Block
Las Vegas, NV
03.2022 - 09.2022
Provided customer support during companies peak season for new and experienced tax experts.
Most candidates were calling about application status, upcoming classes, and pay questions.
Assisted with conducting background checks and orientation, coordinating new employee onboarding process.
Remote position for H&R Block 'The People's Center'. A top competitor in the tax industry. A nationwide company that offers exceptional tax services.
Remote position for H&R Block 'The People's Center'. A top competitor in the tax industry. A nationwide company that offers exceptional tax services.
Member Service Representative
Kelly Services
Las Vegas, NV
04.2021 - 10.2021
Stayed calm under pressure to and successfully dealt with difficult situations.
Directed HR programs, policies and processes to improve operational efficiency.
Handled sensitive employee and company information with highest level of confidentiality and discretion.
Safeguarded human resource information, maintaining employee confidence and protecting operations.
Assisted candidates with application processes by answering questions about application, performing background checks, providing I-9 forms and handling drug screening paperwork electronically.
Provided essential support to address individual HR needs of employees including pay roll questions, benefits questions, and walking employees through the application process.
Gathered information about each position and related occupation with employee interviews, field observations, and industry research.
Remote position for staffing agency Kelly Services Inc. Anthem Health Insurance for members with California Large Group which is an Employer based plan.
Remote position for staffing agency Kelly Services Inc. Anthem Health Insurance for members with California Large Group which is an Employer based plan.
Customer Service Representative
Willis Towers Watson
Las Vegas, NV
10.2020 - 02.2021
Helped members find in network doctor's and specialists within their area.
Assisting members with questions about prescriptions, including formulary questions.
Helped with getting members connected to the appropriate department for prior-authorization's, and helped with overrides.
Explained explanation of benefits or pharmacy summaries.
Collected deposits or payments and arranged for billing.
Helped with any billing questions to confirm patient liability and accumulator's were up to date.
Assisted with review of claim inquiries and CPT coding when applicable.
Built trust and rapport with prospective patients to understand treatment needs and determine appropriate level of care.
Connected with medical professionals to help members with the proper referrals to help obtain health care services and access available resources.
Instructed patients on policies and required actions for different types of appointments and procedures.
Obtained proper authorization and identification to release confidential medical records.
Engaged in conversation with customers to understand needs, resolve issues and answer insurance questions.
Identified issues, analyzed information and provided solutions to problems.
Willis Towers Watson is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth.
Willis Towers Watson is a leading global advisory, broking and solutions company that helps clients around the world turn risk into a path for growth.
Customer Care Representative
State Of CA Elder & Disabled Supportive Services
Victorville, CA
08.2018 - 04.2019
Some of the daily job duties consisted of helping residents with cooking, cleaning, and preparing for doctor's appointments, or daily errands.
One of our main goals would be to provide excellent service by making sure our members were safe, loved, and given top quality service in and out the home.
Helping maintain daily living by keeping home clean and sanitized during the pandemic due to COVID-19.
Maintained clean personal areas and prepared healthy meals to support client nutritional needs.
Assistance with cooking 2-3 meals per day if needed.
Transportation provided to and from doctor's appointments, or for daily errands.
Transported individuals to events and activities, medical appointments, and shopping trips.
Provided help with lifting heavy objects, or major moving with certain restrictions.
Supported daily hygiene needs of patients by assisting with bathing, dressing, dental care and personal grooming.
Assistance with bathing and washing on a daily basis.
Engaged patients in meaningful conversation, socialization, and activity while providing personal care assistance.
Built strong relationships with clients to deliver emotional support and companionship.
The In-Home Supportive Services program provides in-home assistance to eligible aged, blind, and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their homes.
The In-Home Supportive Services program provides in-home assistance to eligible aged, blind, and disabled individuals as an alternative to out-of-home care and enables recipients to remain safely in their homes.
Customer Service Representative
Sitel
Las Vegas, NV
09.2017 - 08.2018
Primary duties consisted of troubleshooting JUUL products for thousand of customers.
Maintained customer loyalty by providing fast, friendly and knowledgeable service for routine questions and product complaints.
Disposed of damaged or defective items or coordinated returns to vendors for covered items.
De-escalated customer issues with proven conflict mediation and problem-solving abilities.
Followed up on emailed or web-submitted customer inquiries within the first twenty four hours.
Documented conversations with customers in Salesforce to track requests, problems and solutions offered.
Enhanced customer satisfaction ratings by effectively resolving issues, and keeping customers updated on the best offers available at the time of contact.
Delivered exceptional customer service to every customer by leveraging extensive knowledge of products and services and creating welcoming, positive experiences.
Sitel is a privately owned customer experience technology company providing customer support for large companies.
Sitel is a privately owned customer experience technology company providing customer support for large companies.
Customer Service Representative
Customer Contact Channels
Las Vegas, NV
11.2015 - 01.2017
My job duties consisted of receiving inbound calls for Humana Medicare advantage members, as a third party vendor, including working with Humana Pharmacy.
Dealing with individuals on a daily basis regarding inquiries about Medicare managed plans benefits and medication questions.
Most members were on Medicare or retired and had questions about open enrollment, over the counter credits, and premium questions.
Assisted members with questions regarding claims, copays, deductibles, and coinsurance's when applicable.
Maintained confidential patient, employee and company information in compliance with company policies and regulatory requirements.
Used company knowledge bases to comply with HIPPA requirements and provide accurate information.
Asked probing questions to determine service needs and accurately input information into electronic systems.
Cultivated impactful relationships with customers and drove business development by delivering product knowledge by giving members the correct benefit information when needed.