Kaylin Alexander
Douglasville,GA
Summary
Dedicated professional with 6+ years of experience in healthcare, insurance, and high-volume call center environments. Proven success resolving billing concerns, claims inquiries, account issues, and benefit questions while delivering excellent customer experiences. Skilled in CRM systems, documentation, compliance standards, and handling sensitive information under HIPAA guidelines. Recognized for professionalism, strong communication, problem-solving, and consistently meeting performance metrics. Seeking a full-time opportunity to contribute strong service skills, operational excellence, and long-term value to a growing organization.
Overview
6
6
years of professional experience
Work History
Member Support Representative
Aspen Dental
Atlanta, GA
01.2023 - Current
- Oversaw high-volume call traffic of 50 to 100 calls, ensuring precise and attentive resolution of customer and member inquiries.
- Analyzed health plan coverage eligibility criteria, deductible structures, and policy specifics to improve client comprehension.
- Investigated and rectified multifaceted problems, maintaining adherence to company policies and healthcare compliance.
- Maintained accurate and thorough call records in CRM systems to ensure effective communication and follow-up.
- Monitored and safeguarded sensitive member and patient information to uphold HIPAA regulations.
- Monitored and enhanced performance metrics to ensure high standards in call quality, productivity, and customer satisfaction.
- Managed escalation processes for intricate or unresolved issues to designated departments, maintaining accountability for follow-up actions.
- Assisted patients with appointment scheduling and insurance inquiries to streamline processes.
- Provided exceptional customer service to enhance patient satisfaction and loyalty.
Customer Care Specialist
OptumRx
Atlanta, GA
01.2020 - 01.2023
- Facilitated efficient communication by handling high-volume inbound and outbound calls to enhance patient support services.
- Addressed member account updates, service requests, and billing concerns to enhance customer satisfaction.
- Executed efficient navigation through various systems while ensuring data accuracy.
- Analyzed customer interactions to identify trends and implement strategies that boosted productivity by 10 percent.
- Monitored compliance with established internal procedures and service standards to uphold quality.
- Engaged with diverse customer groups to offer empathetic, focused solutions that addressed individual concerns.
- Managed resolution of customer inquiries to support overall satisfaction and strengthen loyalty.
- Engaged with cross-functional teams to refine service processes, resulting in improved efficiency and faster response times.
- Responded to customer inquiries, providing accurate information regarding prescriptions and health plans.
- Assisted in resolving complex customer issues, ensuring high levels of satisfaction and retention.
- Collaborated with pharmacy teams to streamline processes, enhancing overall service efficiency.
- Utilized CRM systems to track interactions and maintain detailed records of customer communications.
Member Support Specialist
Care Source Health Plan
Atlanta, GA
01.2023 - Current
- Provided phone, email, chat support for members regarding benefits, claims, and account
- Coordinated benefits enrollment processes, ensuring accuracy and compliance with healthcare regulations.
- Collaborated with cross-functional teams to streamline communication and enhance member services.
- Implemented process improvements that reduced response times and increased overall operational efficiency.
- Leveraged knowledge of products and services when assisting customers with inquiries, contributing to increased upsell opportunities.
- Trained new team members in best practices for efficient and consistent member support delivery.
- Engaged in team discussions to identify strategies for improving customer experience by 15 percent throughout the organization.
- Helped large volume of customers every day with positive attitude and focus on customer satisfaction.
- Analyzed member feedback to identify trends and recommend improvements in support processes.
Education
Dental Assisting - Dental
Fortis College
Austell, GA01-2024
High School Diploma -
Thornridge High School
Dolton, IL05-2010
Skills
Customer satisfaction orientation
Facilitation of member involvement
Claims processing proficiency
Payment transaction facilitation
Insurance benefits validation
Customer engagement strategies
Inbound and Outbound Calls
Innovation process optimization
Case management
HIPAA compliance
Invoice processing
Account relationship development
PROFESSIONAL EXPERIENCE
01-2023
Timeline
Member Support Representative
Aspen Dental
01.2023 - Current
Member Support Specialist
Care Source Health Plan
01.2023 - Current
Customer Care Specialist
OptumRx
01.2020 - 01.2023
Dental Assisting - Dental
Fortis College
High School Diploma -
Thornridge High School