Results-driven customer service professional with over 10 years of experience delivering exceptional customer experiences and driving service excellence. Seeking to leverage proven skills within a respected organization committed to world-class customer service.
Overview
11
11
years of professional experience
Work History
Grievance & Appeals
One Home Care Solutions (Humana)
02.2023 - Current
100% remote
Investigated and reported findings to the Humana Ethics office within the specified SLA depending on the severity of the complaint.
Monitored the Birdeye portal and responded to recently submitted surveys with a satisfaction score of 7 or less.
Monitored the Escalation dashboard on a rotating schedule and investigated all cases where there were 3 or more member/call center interactions per day.
Provided a neutral analysis of call interactions with a goal of improving the Member experience and preventing future complaints and grievances.
Outbound calls during hurricane season to provide DME products
Customer Service Rep
America’s Pharmacy Source
Akron, Ohio
04.2019 - 12.2022
Inbound calls for mail order pharmacy
Enrollment applications over the phone for discount program
Processed mail order prescriptions orders
Provided discount on prices on medications
Processed payroll approval and tracked attendance policy adherence
Customer Care Representative
CVS Caremark
Solon, Ohio
05.2017 - 04.2019
Answered inbound calls
Inquiries, processing new and refill prescription orders
Demonstrated expertise with call center computer applications by educating representatives to become proficient with navigation of several systems
Applications for Medicare Part D prescription drug plans
Customer Service Representative/ Team lead
Envision Rx Options
Twinsburg, Ohio
01.2015 - 05.2017
Assisted Customer Care Representatives with daily task completion and call handling
Processed Prior Authorizations over the phone increasing member satisfaction
Handled member call escalations
Inbound calls for Medicare Part D and Commercial PBM plans
Recommended Plan Benefits Overrides process improvement increasing the efficiency of member obtaining prescribed medications
Answering heath plan and call quality questions
Answered member inquiries on Medicare Part D plans
Ensured exceptional service establishing rapport with members
Researched, calmed, and rapidly resolved member issues preventing loss of plan membership