Monica Mulinge
Wylie,TX
Summary
Hardworking candidate skillful in providing excellent customer service. Proven track record of resolving customer issues in a timely manner while upholding the highest standards of customer satisfaction. Extensive experience in using multiple communication channels, including phone, email, and web chat. Strong interpersonal skills, and an ability to lead and motivate a team to success.
Overview
4
4
years of professional experience
Work History
Remote Customer Care Specialist
Navitus
Appleton, WI
10.2023 - Current
- Understand, apply, and communicate client-specific prescription benefit and pharmacy claim processing information.
- Educate members on how to best utilize their benefits.
- Troubleshoot pharmacy claims real-time to include verifying information the pharmacy submits, comparing the claim result to benefit rules, and entering allowed overrides to allow claims to pay.
- Send documents to providers electronically.
Follow up and provide superior service through outbound calls as necessary. - Anticipate and address questions to prevent repeat calls in order to delight customers and reduce customer effort.
- Treat all customers with respect and display empathy.
Remote Customer Service Specialist
Sedgwick
Memphis, TN
05.2023 - 09.2023
- Enters verbal and written application information that meets internal and external customer requirements accurately into the claims management system.
- Contacts the customer by telephone, written correspondence, and/or the claims system regarding documentation required to process a claim, required time frames, and claim status
- Communicates clearly and professionally with the customer by telephone and/or written correspondence regarding all aspects of the claims process.
- Expedited the Customer Service claims application process; to ensure correct case assignment; and acted as a customer liaison in assisting the customer with the correct contact person to resolve problems and/or questions.
Remote Medical Claims Associate
State Farm Mutual Insurance Company
Richards, TX
10.2021 - 12.2022
- Comprehensive knowledge of PIP/MPC regulations for 4 states Knowledge of Mitchell Code billing
- Explain relevant coverage information and pay claims within the authority granted and the state's regulations
- Communicating with customers and associates over the phone and other communication channels
- Using State Farm claims systems and other technologies to gather the necessary information to handle claims.
Remote Social Media Analyst
Genpact
Richards, TX
07.2020 - 08.2021
- Used statistical tools to identify, analyze and interpret patterns and trends in complex data sets
- Ensured the safety of user-generated content while maintaining and implementing security standards for all content
- Managed all content creation, developed and scheduled posts, managed and responded to consumer comments and reviews, and created e-reports
- Used automated tools to extract data from primary and secondary sources
- Collaborated with other departments to ensure brand consistency and communicated social media analytics monthly.
Guest Service Representative
Racetrac
Wylie, TX
03.2020 - 06.2020
- Preparing daily records of food and gas sales and balancing register drawers
- Processing payments via cash, credit, and debit cards and counting back change to customers to avoid cash drawer errors
- Answering customers' questions and addressing problems and complaints in person and via phone
- Maintaining cleanliness, neatness, and organization of all areas
- Receiving incoming product deliveries and relocating them to storage shelves, coolers, or bins.
Education
Some College (No Degree) - Psychology
Collin Community College
McKinney, TXSkills
- 3 years of experience working collaboratively in a team environment on various STEAM projects
- Highly motivated and self-directed with a strong sense of ownership
- Ability to build and maintain strong working relationships across workgroups
- Strong communication & organizational skills with the ability to handle multiple tasks simultaneously
- Working knowledge of MS Office and Google Drive
- Flexibility to change direction quickly based on business needs
- Cash transactions
- Administrative skills
- Analytical mastery
- Hospitality services
- Communicating skills
- NexGen knowledge
- Customer Relationship Management
- Process Optimization
- Customer Service and Assistance
- Energy Conservation
- Carrier Relations
- Cash Register Operations
- Call Centers
Custom
- Inputting Claims
- Senior Leadership Support
- Customer Service
- Project Management
- Effective Written and Verbal Communication
- Customer Order Management
- Good Communication Skills
- Adobe Dreamweaver
- Valid Driver's License
- Customer Relations
- Data Evaluation
- Participant Screening
- Complaint Reviews
- Schedule Mastery
- E-Commerce Strategy
- Benefits Explanations
- Team-Building Exercises
- Regulatory Compliance
- Field Operations Support
- High-Volume Call Environments
- Complex Transactions
- Excellent Written and Oral Communication
- Microsoft Office
- Persuasive Techniques
- Telephone Etiquette
- Aircraft Dispatch
- Creative Solutions
- Problem Resolution
- Collaborative Environments
- Claim Validity Determination
- Sales Report Generation
- Portal Systems
- Credits Understanding
- Quality Deliverables
- POS Systems and Ordering Platforms
- Office Supplies and Inventory
- Understanding Customer Needs
- Policy and Procedure Adherence
- Microsoft Access
- Merchandise Orders and Exchanges
- Invoice Preparation and Processing
- Interpretation and Translation Services
- Document and Records Management
- Membership Inquiries and Renewals
- Online Chat
- Issue and Complaint Resolution
- Trained in Salesforce
Timeline
Remote Customer Care Specialist
Navitus
10.2023 - Current
Remote Customer Service Specialist
Sedgwick
05.2023 - 09.2023
Remote Medical Claims Associate
State Farm Mutual Insurance Company
10.2021 - 12.2022
Remote Social Media Analyst
Genpact
07.2020 - 08.2021
Guest Service Representative
Racetrac
03.2020 - 06.2020
Some College (No Degree) - Psychology
Collin Community College
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