Open To Work
Melissa Bain
Fidelis Care
Buffalo,New York
Work Preference
Desired Job Title
Health Benefit RepresentativeRetention RepresentativeCustomer Service RepresentativeWork Type
Full TimeLocation Preference
On-SiteRemoteHybridLocation:
Buffalo, New York, USBuffalo, NYOpen to relocation:
NoImportant To Me
Career advancementWork-life balanceCompany CultureFlexible work hoursPersonal development programsHealthcare benefitsPaid time off401k matchSummary
Demonstrates strong analytical, communication, and teamwork skills, with proven ability to quickly adapt to new environments. Eager to contribute to team success and further develop professional skills. Brings positive attitude and commitment to continuous learning and growth.
13
years of professional experience
Work History
Health Benefit Representative
9 Years 9 Months- Educated members on health benefit options and eligibility requirements.
- Processed member inquiries, ensuring accurate and timely responses.
- Assisted with claims resolution, enhancing member satisfaction through effective communication.
- Developed training materials for new representatives, fostering knowledge sharing and consistency.
- Ensured compliance with federal regulations governing Health Benefit Representative activities and reporting requirements.
- Provided timely communication updates regarding ongoing claim status or necessary documentation requests from members or medical providers.
- Coordinated open enrollment activities, ensuring seamless transitions between old and new coverage periods for all clients served by the organization.
- Improved customer satisfaction by addressing and resolving complex health benefit inquiries.
- Facilitated enrollment process for new members, ensuring smooth transition from previous insurance providers.
- Developed and managed personal book of business with 2000 clients.
Retention Representative
1 Year 6 Months- Led cross-functional teams to implement process improvements, increasing efficiency in retention operations.
- Facilitated customer engagement initiatives to enhance retention strategies and improve overall satisfaction.
- Analyzed customer feedback and trends to develop targeted outreach programs and support efforts.
- Mentored junior representatives on best practices for customer relationship management and retention tactics.
- Promoted a positive work environment by fostering teamwork, communication, and mutual support among colleagues.
- Monitored performance metrics to ensure alignment with company goals related to retention and customer satisfaction.
- Managed high call volume, maintaining professionalism and efficiency in all interactions.
- Exceeded performance expectations consistently while handling challenging situations such as irate customers or complex billing disputes.
- Implemented and assisted in developing CRM system to the department.
Customer Service Representative
1 Year 5 Months- Resolved customer inquiries through effective communication and problem-solving techniques.
- Collaborated with cross-functional teams to enhance customer service processes and improve satisfaction.
- Maintained accurate records of customer interactions using CRM software for future reference and analysis.
- Trained new team members on company policies and procedures to ensure high service standards.
- Managed high-stress situations effectively, maintaining professionalism under pressure while resolving disputes or conflicts.
- Resolved customer complaints with empathy, resulting in increased loyalty and repeat business.
- Responded to customer requests for products, services, and company information.
- Developed strong product knowledge to provide informed recommendations based on individual customer needs.
- Maintained detailed records of customer interactions and transactions, ensuring accurate documentation and follow-up.
- Educated customers about billing, payment processing and support policies and procedures.
Education
Cosmetology License - Cosmetology
Associate of Applied Science - Medical Assisting
Skills
HIPAA compliance
Claims processing
Insurance verification
Benefit communication
Customer service management benefits
Data analysis
Records maintenance
Investigation skills
Problem-solving
Attention to detail
Analytical skills
Time management
Multitasking
Critical thinking
Active listening
Client education
Accomplishments
Obtained highest quality score out of Buffalo and Rochester regional teams.
Timeline
Health Benefit Representative
Fidelis Care
10.2016 - Current
Retention Representative
Fidelis Care
04.2015 - 10.2016
Customer Service Representative
Fidelis Care
11.2013 - 04.2015
Continental School Of Beuty
Cosmetology License from Cosmetology
Bryant & Stratton College
Associate of Applied Science from Medical Assisting