Driven professional with extensive experience in customer service and pharmacy operations, notably at Centene. Excelled in problem resolution and process improvement, leveraging skills in data entry. Achieved first call resolution and enhanced service quality, demonstrating a commitment to efficiency, accuracy, and patient care.
Overview
12
12
years of professional experience
Work History
Customer Care Advocate II
Centene
7700 Forsyth Boulevard St. Louis, MO 63105
11.2022 - Current
Leveraged strong listening skills to identify member’s needs and recommend appropriate solutions or alternatives..
Reference current materials to answer escalated and complex inquiries from members and providers regarding claims, eligibility, covered benefits, and authorization status matters.
Provide assistance to members and/or providers on health plan initiatives.
Provide first call resolution working with appropriate internal/external resources and closure of inquiries.
Document all activities for quality and metrics reporting through the customer relationship management application.
Process written customer correspondence and provide the appropriate level of follow up in a timely manner
Research and identify processing inaccuracies in claim payments and route to the appropriate team for claim adjustments.
Identify trends related to and/or provider inquiries that may lead to police or process improvements that support excellent customer service and impact quality and performance standards
Work with other departments on cross functional tasks and projects
Maintain performance and quality standards based on established call center metrics including turn around times
Assisted in the preventive service outreach campaign and made sure members were competing their health screenings that were due and reach out to providers to help schedule those appointments
Assisted with inbound campaign and provided clear answers and education of members needs through those calls
Assisted with ninety day onboarding campaign to ensure members were aware of their benefits and how to make the most of them.
Assisted in allowing new agents and current agents to shadow calls and accurately provide answers to any questions they may have
Contributed to process improvements by offering valuable input during team meetings
Customer Service Representative Agent
General Dynamics
Barbourville, KY
08.2022 - 10.2022
Answered customer telephone calls promptly to avoid on-hold wait times
Managed high call volume, consistently maintaining a professional demeanor and prioritizing customers' needs.
Built rapport with customers through active listening, empathy, and understanding of their individual needs.
Pharmacy Technician
Vicco Pharmacy
Vicco, KY
01.2021 - 07.2022
Performed a wide range if pharmacy operations with strong commitment to accuracy, efficiency, and service quality.
Answered incoming phone calls and addressed questions from customers, healthcare providers, and insurance companies.
Stocked, labeled, and inventoried medication to keep accurate records.
Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
Attended to patients and answered all their questions accurately and assisted with their pharmacy needs in a timely manner.
Proper drug storage procedures, registries, and records for controlled drugs.
Ensured that patients prescriptions were properly entered and processed into the internal system.
Pharmacy Technician
Vicco Prescription Center
Vicco, KY
05.2014 - 12.2020
Performed a wide range if pharmacy operations with strong commitment to accuracy, efficiency, and service quality.
Answered incoming phone calls and addressed questions from customers, healthcare providers, and insurance companies.
Stocked, labeled, and inventoried medication to keep accurate records.
Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
Attended to patients and answered all their questions accurately and assisted with their pharmacy needs in a timely manner.
Proper drug storage procedures, registries, and records for controlled drugs.
Ensured that patients prescriptions were properly entered and processed into the internal system.
Pharmacy Technician
East Kentucky Pharmacy
Hindman, Ky
01.2012 - 05.2014
Performed a wide range if pharmacy operations with strong commitment to accuracy, efficiency, and service quality.
Answered incoming phone calls and addressed questions from customers, healthcare providers, and insurance companies.
Stocked, labeled, and inventoried medication to keep accurate records.
Enhanced pharmacy workflow by assisting pharmacists with medication dispensing, labeling, and packaging.
Calculated dosage, filled prescriptions, and prepared prescription labels with absolute accuracy.
Attended to patients and answered all their questions accurately and assisted with their pharmacy needs in a timely manner.
Proper drug storage procedures, registries, and records for controlled drugs.
Ensured that patients prescriptions were properly entered and processed into the internal system.