Miriam Louden
Hartland,Mi.
Summary
Bilingual Customer Service Representative – Customer Advocacy Specialist.
More than 15 years on 4 C's & 5 A's of experience, handling customer inquiries, answering complaints
via phone, email, video calls, social media in a timely manner in the language the customer is
comfortable with. Translating, explaining, and providing product information in detail, services, and
other information as required inside company standard compliance. Centralizing, respecting,
performing, keeping, and following company policies and procedures. Providing translation and
interpretation services as required. Documenting customer interactions, records of inquiries,
complaints, and comments as well as actions taken, document and update customer records based
on interactions troubleshoot and resolve product issues and concerns. Facilitating communication
between customers and company departments. Strong phone contact handling skills and active
listening. Ensuring customer satisfaction by providing accurate information and viable solutions to
their problems, maintaining a deep understanding of the company products or services to provide
better assistance to customers develop and maintain a knowledge base of the evolving products and
services assisting with the of marketing materials, website content, and other documents as needed,
ability to multitask, prioritize, and manage time effectively using Google Sheets, Slack, Zoom, Live
Chat Software, various software and tools to provide effective customer service, provide feedback to
the team on customer needs, problems, interests, and potential for products and services. Respecting
and following company confidentiality and privacy procedures, HIPAA as well.
Overview
15
15
years of professional experience
2
2
Language
Work History
Bilingual Customer Service Representative
Everise - Wellcare by
10.2023 - Current
- Allwell - CarelonRx Pharmacy Work from home, Educates customers regarding products and services
- Utilizes and navigates multiple systems simultaneously
- Resolve customer issues via one call resolution guidelines and/or escalated process
- Understanding and compassion to answer inbound phone calls for our clients' members
- Answer questions related to their healthcare benefits Demonstrated passion for excellence with respect to treat and caring for customers, especially senior citizens, Strong decision making and analytical abilities
- Ab to identify customer needs and clearly articulate products and services
- Schedule flexibility occasional overtime
- Take a patient order prescription and Refills
- Highly developed sense of integrity and commitment to customer satisfaction
- Meet all attendance and dependability requirements
- Member Services
- English – Spanish.
Operator
Faurecia Interior Systems
Saline, MI
08.2015 - 09.2023
- Making and foaming parts for Tesla
Operator
Phoenix Services
Ann Arbor, MI
03.2015 - 08.2015
- Production of auto body parts on assembly line, Fast paced environment to complete numbers expected for the day, check parts and inspect for quality, working to fulfill the expectations of managers.
Ralph Lauren Polo Incorporated
Greensboro, NC
03.2014 - 03.2015
- Shipping and Packing Dept
- Pick Pack
- Collections
- Quality Control
- Inventory
Admissions Representative
LIMA – PERU, Clínica Centenario Peruano Japonés
Lima
07.2008 - 12.2011
- Hospital
- Interviews patients on admission, records required personal information, provides patients with information by explaining hospital admission policies, time of admission, room selection
- Secures signatures, prepares, and supplies patient data to appropriate hospital departments.
Health Insurance Advisor, Patient Admission Representative
Clínica Vesalio
Lima
01.2005 - 06.2008
- Provides financial advice to patients, investing, and protecting against risks, utilizing patients' electronic health records to code medical procedures and examine insurance claims maintain meticulous records of medical costs, adjustments, co- payments, and other billing details.
Patient Admission Representative
Clinic Private
12.1998 - 12.2004
- Performs pre-admitting activities, receives bookings from physicians and interviews patients before admission to obtain required information and to explain hospital policies
- Screens insurance information to identify patients needing preadmission approval from third-party payors.
Education
PDP Drug Cost and Benefits Structure, ENT CVS Health COS Basis. Call Center Training – Managing Difficult Calls. Creating Positive Conversations with Challenging Customers ENT Issue Identification Intelligence CS Handling Member Health Reminders, call Listening, Schedule Overview for Service Desk. CS AWS Amazon Connect Control Panel, Hands-On Amazon Connect Control Panel, MPS COE Global Medicare. - undefined
2024
Medicare Advantage Products and Benefits Changes. - undefined
2024
Medicare Advantage Ancillary Benefits. - undefined
2024
Medicare Advantage Member Communications. - undefined
2024
CS - undefined
2024
Medicare Advantage Processes and Tools. - undefined
2024
Medicare Advantage MAPD Prescription Basics. CS - undefined
2024
PDP prescription Basis. - undefined
2024
Complaint Mitigation CS 2024 PDP Benefits Overview. - undefined
2004
CS Medicare Centene Quality call Customer Service excellence CS steps a Customer - undefined
Centene University
CS Specialty Managed Care Plan Overview PPO, PFFS and PO. Premium Billing Module Billing and Payment intent. CS Medicare Claims and Status, Claims. Authorization. - undefined
CS Medicare - undefined
ENT - undefined
Medicare Advantage Drug Cost and Benefits Structure - undefined
PDP Call Listening Seminaries Customer Services Representative - undefined
Seminaries Customer Advocacy Specialist. Health Insurance Adviser Training Instituto Superior Technologic Privado José - undefined
Félix
Computer Technician - undefined
Instituto Superior Technologic Hugo Pesce Pescetto Lima
Perú Microsoft Office. - undefined
High school - undefined
Albert Einstein CEP
References
REFERENCE
Available upon request
Timeline
Bilingual Customer Service Representative
Everise - Wellcare by
10.2023 - Current
Operator
Faurecia Interior Systems
08.2015 - 09.2023
Operator
Phoenix Services
03.2015 - 08.2015
Ralph Lauren Polo Incorporated
03.2014 - 03.2015
Admissions Representative
LIMA – PERU, Clínica Centenario Peruano Japonés
07.2008 - 12.2011
Health Insurance Advisor, Patient Admission Representative
Clínica Vesalio
01.2005 - 06.2008
Patient Admission Representative
Clinic Private
12.1998 - 12.2004
PDP Drug Cost and Benefits Structure, ENT CVS Health COS Basis. Call Center Training – Managing Difficult Calls. Creating Positive Conversations with Challenging Customers ENT Issue Identification Intelligence CS Handling Member Health Reminders, call Listening, Schedule Overview for Service Desk. CS AWS Amazon Connect Control Panel, Hands-On Amazon Connect Control Panel, MPS COE Global Medicare. - undefined
Medicare Advantage Products and Benefits Changes. - undefined
Medicare Advantage Ancillary Benefits. - undefined
Medicare Advantage Member Communications. - undefined
CS - undefined
Medicare Advantage Processes and Tools. - undefined
Medicare Advantage MAPD Prescription Basics. CS - undefined
PDP prescription Basis. - undefined
Complaint Mitigation CS 2024 PDP Benefits Overview. - undefined
CS Medicare Centene Quality call Customer Service excellence CS steps a Customer - undefined
Centene University
CS Specialty Managed Care Plan Overview PPO, PFFS and PO. Premium Billing Module Billing and Payment intent. CS Medicare Claims and Status, Claims. Authorization. - undefined
CS Medicare - undefined
ENT - undefined
Medicare Advantage Drug Cost and Benefits Structure - undefined
PDP Call Listening Seminaries Customer Services Representative - undefined
Seminaries Customer Advocacy Specialist. Health Insurance Adviser Training Instituto Superior Technologic Privado José - undefined
Félix
Computer Technician - undefined
Instituto Superior Technologic Hugo Pesce Pescetto Lima
Perú Microsoft Office. - undefined
High school - undefined
Albert Einstein CEP
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