Nicole Lumives

• Conducted thorough investigations into member grievances regarding services, coverage, and claims disputes.
• Maintained detailed records summarizing investigations, root causes, and resolution outcomes.
• Crafted over 50 written resolutions for customer complaints, enhancing satisfaction by 30%.
• Performed witness interviews and document reviews to support grievance resolutions.

• Evaluated customer complaints to determine eligibility for grievance or appeal processes.
• Analyzed complex cases to ensure resolutions complied with relevant laws and policies.
• Drafted comprehensive written responses outlining outcomes of appeal or grievance filings.
• Resolved over 100 post-service appeals and grievances, improving service quality through detailed reporting.

• Served as primary contact for Stanford Healthcare Medical Group members, ensuring effective communication.
• Resolved customer conflicts through strategic solutions, enhancing overall service quality.
• Assisted callers with inquiries related to health plans, medical claims, and billing issues.
• Maintained customer satisfaction by addressing problems with knowledgeable, and friendly service.

• Created tailored vacation packages including flights, cruises, hotels, and car rentals.
• Researched optimal hotel and airfare selections to improve client satisfaction.
• Delivered exceptional customer service, building lasting relationships and securing new travel assignments.
• Specialized in cruise options from Carnival, Celebrity, Royal Caribbean, Princess, and NCL.

• Managed HR support and benefit administration for multi-channel contact center operations.
• Educated customers on navigating employer benefit plans, ensuring efficient enrollment and changes.
• Effectively addressed complex issues by managing escalated calls as team lead assistant.
• Contributed to development of training programs for new staff members.

• Processed federal and state income tax returns for individuals and small businesses, ensuring compliance with current tax laws.
• Identified potential deductions and credits for clients using tax software to maximize returns.

Service for The Ambassador Chicago Hotel

• Managed reservations system to maintain accurate booking records and availability.
• Operated PBX for room service orders, ensuring knowledgeable recommendations and timely deliveries.
• Delivered concierge services while efficiently handling diverse guest requests.