Summary
Overview
Work History
Education
Skills
Timeline
Generic

Melissa Tamayo

Miami,FL

Summary

Dynamic customer service advocate with United Healthcare, skilled in benefits education and claims. Proven track record in enhancing member engagement and resolving complex issues. Adept at project coordination and team training, consistently exceeding performance goals while fostering strong customer relationships. Bilingual communicator dedicated to delivering exceptional support and solutions.

Overview

17
17
years of professional experience

Work History

Customer Service Advocate

United Healthcare
Miami, Florida
08.2022 - Current
  • Assist caller with benefits, eligibility, and claims concerns.
  • Educate members about their benefits and maximize the value of their health plan benefits.
  • Assist members with provider’s search.
  • Outreach to members as needed, which may involve welcoming new members to our health plans, addressing gaps in care, and reviewing coverage.
  • Contact care providers on behalf of members to assist with appointments.
  • Assist members with resources UHC offers.
  • Assist with projects and commitments.
  • Assist members with transportation.
  • Make outbound calls as necessary.
  • Performs other related duties as assigned.
  • Meet the performance goals established for the position in the areas of efficiency, call quality and attendance.
  • Participated in a pilot for the public health emergency redetermination campaign.
  • Worked on state specifics with multiple more programs sometimes having to work unsupervised with a workload of 15,000 files that you had to get through for the month and the campaigned has been a success.
  • Experience analyzing and solving appeals and grievances in a office environment using telephone and computer as the primary source to perform job duties.
  • Experience in medical claims and billing process.

Store Manager

Nessy's Puppies LLC
Miami, Florida
04.2018 - 08.2022
  • Managed daily operations and ensured excellent customer service at pet retail store.
  • Oversaw inventory management and maintained stock levels for pet supplies.
  • Developed promotional strategies to enhance sales of puppies and accessories.
  • Trained and mentored staff on product knowledge and customer engagement techniques.
  • Scheduled employee shifts to optimize staffing during peak business hours.
  • Recruited, trained and supervised new employees.
  • Conducted daily store operations, including opening and closing procedures and cash handling.
  • Resolved customer complaints in a timely manner.
  • Created weekly work schedules for store personnel.

Supervising Manager

G.T Installation Services
Miami, Florida
05.2008 - 01.2018
  • Supervised installation teams to ensure compliance with safety regulations.
  • Coordinated project schedules and resource allocation for timely completion.
  • Trained new employees on installation procedures and company protocols.
  • Led quality control inspections to maintain high service standards.
  • Facilitated communication between clients and installation teams for project clarity.
  • Implemented process improvements to streamline workflow and efficiency.
  • Monitored team performance, identified areas for improvement, and provided constructive feedback to staff members.

Education

Bachelor of Science - Education

Barry University
Miami, FL
05-2006

Skills

  • Benefits education
  • Claims processing
  • Time management
  • Customer support
  • Provider search
  • Customer relationship management
  • Bilingual communication
  • Customer engagement
  • Project coordination
  • Team training
  • Problem solving
  • Staff training
  • Microsoft Office

Timeline

Customer Service Advocate

United Healthcare
08.2022 - Current

Store Manager

Nessy's Puppies LLC
04.2018 - 08.2022

Supervising Manager

G.T Installation Services
05.2008 - 01.2018

Bachelor of Science - Education

Barry University

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